Treatment of severe scleroderma skin ulcers with recombinant human erythropoietin.
Systemic sclerosis (SSc) is frequently complicated by skin ulcers, often unresponsive to traditional treatments. A preliminary evaluation of the effects of recombinant human erythropoietin (rHuEPO) was carried out in 14 patients with SSc with nonhealing, severe cutaneous ulcers. Patients received rHuEPO subcutaneously at a dosage of 150 IU/kg 3 times weekly for 2 weeks, twice weekly for the next 2 weeks, and then once weekly for 1 month. At follow-up 3-6 months from the beginning of the treatment, six patients showed complete resolution of the skin ulcers, while a significant reduction (> 60%) in lesional areas was obtained in the other eight patients (mean +/- SD ulcer area reduced from 27.6 +/- 28 to 5.3 +/- 7.8 cm(2); P<0.005). Moreover, patients' quality of life significantly improved (pain, as measured on visual analogue scale reduced from 96 +/- 5 to 46 +/- 17 points; P=0.0001; disability as measured by the Health Assessment Questionnaire-Disability Index reduced from 1.6 +/- 0.5 to 0.9 +/- 0.4 points; P=0.0001). The rHuEPO may represent a novel treatment of nonhealing scleroderma skin ulcers, suggesting some important aetiopathological implications.
Ferri
C
C
Department of Internal Medicine, University of Modena e Reggio Emilia, Medical School, Modena, Italy. clferri@unimo.it
Giuggioli
D
D
Sebastiani
M
M
Colaci
M
M
D000328:Adult; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D011994:Recombinant Proteins / Q000627:therapeutic use; D012595:Scleroderma, Systemic / Q000188:drug therapy*; D012883:Skin Ulcer / Q000188:drug therapy*
D011994:Recombinant Proteins; D004921:Erythropoietin