Effects of five-day versus one-day infusion of iloprost on the peripheral microcirculation in patients with systemic sclerosis.
OBJECTIVE
To evaluate the effects of iloprost infusion on the microcirculation in patients suffering from severe Raynaud's phenomenon secondary to systemic sclerosis.


METHODS
Eight patients received a 7-hour infusion of iloprost for five consecutive days and then for one day 3 months later. The effects on vascular distensibility were evaluated by piezoelectric plethysmography before and after the treatment and at 2, 4 and 6 weeks.


RESULTS
The beneficial effects on the peripheral microcirculation were statistically significant after five days of infusion (distensibility index: 0.18 +/- 0.01 vs 0.23 +/- 0.01, p < 0.002) and lasted for less than four weeks, whereas no difference (0.22 +/- 0.04 vs 0.24 +/- 0.02, p: ns) was seen after one day of treatment. One patient suffered from typical angina pectoris with electrocardiographic changes of the ST wave detected during the infusion.


CONCLUSIONS
Our results show that a five-day infusion of iloprost has an effect which lasts from two to four weeks; after four weeks the distensibility index returned to the baseline value. The one-day infusion had no effect on the vascular bed, studied by the piezoelectric pletysmographic method. Treatment with five consecutive days of infusion every four weeks is an impracticable scheme to adopt, however. We have therefore instituted a treatment schedule of a single daily infusion every four weeks with the aim of maintaining the effects induced by the initial five-day infusion. The preliminary results obtained with this schedule are reported.
Ceru
S
S
Institute of Internal Medicine, Policlinico Borgo Roma, University of Verona, Italy.
Pancera
P
P
Sansone
S
S
Sfondrini
G
G
Codella
O
O
De Sandre
G
G
Lechi
A
A
Lunardi
C
C
D000328:Adult; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage* / Q000009:adverse effects; D007262:Infusions, Intravenous; D008833:Microcirculation / Q000187:drug effects / Q000502:physiology; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D010991:Plethysmography / Q000379:methods; D012595:Scleroderma, Systemic / Q000188:drug therapy* / Q000503:physiopathology; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects
D010975:Platelet Aggregation Inhibitors; D014665:Vasodilator Agents; D016285:Iloprost