title: Cyclosporin A and iloprost treatment of systemic sclerosis: clinical results and interleukin-6 serum changes after 12 months of therapy.
abstract: OBJECTIVE
  The main aim was to analyse the long-term therapeutic effects on systemic sclerosis (SSc) patients of treatment with either (i) iloprost alone or (ii) low-dose oral cyclosporin A (CyA) associated with iloprost. A secondary aim was to analyse interleukin-6 (IL-6) serum levels in SSc patients before and after 1 yr of treatment.
  
  
  METHODS
  A clinical trial was performed in which 20 consecutive SSc patients were alternately randomized into two homogeneous groups receiving either monthly i.v. iloprost (1 ng/kg/min in 6 h i.v. infusion, for 5 consecutive days, 1 week per month) (Group I) or low-dose CyA (2.5 mg/kg/day) associated with iloprost administration (Group II). IL-6 concentrations were evaluated by ELISA in the sera of each patient before and after 1 yr of therapy and in 20 healthy subjects.
  
  
  RESULTS
  After 1 yr of therapy, a significant improvement of skin (P=0.008), microvascular (P=0.004) and oesophageal (P=0.05) morphological and functional parameters was observed only in Group II patients. Furthermore, after 1 yr of treatment, a significant reduction (P=0.007) of IL-6 serum concentration was observed only in Group II patients.
  
  
  CONCLUSIONS
  Collectively, our data suggest that the combination of low-dose CyA with iloprost administration may be of clinical utility in SSc and that a mechanism of action of CyA in SSc may include the decrease in IL-6 production.
authors.affiliation: Division of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Filaci
authors.forename: M
authors.initials: M
authors.lastname: Cutolo
authors.forename: M
authors.initials: M
authors.lastname: Scudeletti
authors.forename: C
authors.initials: C
authors.lastname: Castagneto
authors.forename: L
authors.initials: L
authors.lastname: Derchi
authors.forename: R
authors.initials: R
authors.lastname: Gianrossi
authors.forename: F
authors.initials: F
authors.lastname: Ropolo
authors.forename: P
authors.initials: P
authors.lastname: Zentilin
authors.forename: A
authors.initials: A
authors.lastname: Sulli
authors.forename: G
authors.initials: G
authors.lastname: Murdaca
authors.forename: M
authors.initials: M
authors.lastname: Ghio
authors.forename: F
authors.initials: F
authors.lastname: Indiveri
authors.forename: F
authors.initials: F
authors.lastname: Puppo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D016572:Cyclosporine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage*; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D015850:Interleukin-6 / Q000032:analysis / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D012595:Scleroderma, Systemic / Q000097:blood / Q000188:drug therapy*
chemical_list: D007166:Immunosuppressive Agents; D015850:Interleukin-6; D010975:Platelet Aggregation Inhibitors; D016572:Cyclosporine; D016285:Iloprost