title: [Iloprost for severe Raynaud's phenomenon and ischaemic ulcers related with systemic diseases].
abstract: OBJECTIVE
  To evaluate the long term efficacy of treatment with intravenous iloprost for severe Raynaud's phenomenon (RP) and ischemic leg ulcers in patients with autoimmune systemic diseases.
  
  
  METHODS
  Prospective observational study over 2 years with iloprost (intravenous infusions, 0.5 to 2 ng/kg/min, initial cycle of 5 consecutive days and maintenance infusions during 24 h monthly, lengthened when it was needed) in patients with severe RP and ischemic leg ulcers whithout response to conventional therapy. Treatment was halted in patients with a good response after one year of treatment, with regular clinical controls.
  
  
  RESULTS
  We treated 23 patients. Iloprost reduced significantly the mean number (SD) of monthly episodes of RP (150.38 [102.04] initially and 40.05 [78.06] at the end; p < 0.0005), the mean highest duration of episodes of RP (21.86 [26.96] min initially and 7.14 [9.87] min at the end; p = 0.013), the associated pain (p = 0.005), and the mean number of ischemic digital (4.25 [2.86] initially and 0.63 [2.25] at the end; p = 0.003) and leg ulcers (1.67 [0.52] initially and 0.33 [0.52] at the end; p = 0.01). Articular symptoms and inflammatory markers did not improve. Treatment was stopped in 8 patients (in 5 for a very good evolution and in 3 for other causes), and only 1 of them needed to be treated again. Side effects were seen in all cases but always disappeared after slowing infusion.
  
  
  CONCLUSIONS
  Iloprost was effective in the long term treatment of severe RP and ischemic leg ulcers in patients with autoimmune systemic diseases.
authors.affiliation: Unidad de Colagenosis. Servicio de Medicina Interna. Hospital Universitario Virgen del Rocío. Sevilla. España.
authors.forename: Francisco José
authors.initials: FJ
authors.lastname: García Hernández
authors.forename: Celia
authors.initials: C
authors.lastname: Ocaña Medina
authors.forename: Luis
authors.initials: L
authors.lastname: Mateos Romero
authors.forename: Juan
authors.initials: J
authors.lastname: Molinillo López
authors.forename: Andrés
authors.initials: A
authors.lastname: Arias Zambrano
authors.forename: Rocío
authors.initials: R
authors.lastname: González León
authors.forename: Julio
authors.initials: J
authors.lastname: Sánchez Román
mesh_terms: D000328:Adult; D001327:Autoimmune Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use*; D007511:Ischemia / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D007866:Leg / Q000098:blood supply; D007871:Leg Ulcer / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D011446:Prospective Studies; D011928:Raynaud Disease / Q000150:complications / Q000188:drug therapy*; D012720:Severity of Illness Index; D013997:Time Factors; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D016285:Iloprost