[Long-term effects of cyclic therapy with iloprost in systemic sclerosis].
OBJECTIVE
To assess the long-term effects of cyclic infusion of iloprost, a derivative of prostacyclin, on Raynaud's phenomenon-related symptoms and ischemic ulcers in patients with Systemic Sclerosis (SSc).


METHODS
A retrospective analysis of prospectively collected parameters in 59 consecutive SSc patients, followed at one institution, who were treated for a median time of 52 months with iloprost for severe Raynaud's phenomenon and ischemic ulcers.


RESULTS
Among the 50 patients with ischemic ulcers at the start of therapy, 35 (70%) did not show lesions at the last observation. Despite therapy, four patients underwent amputations (two of forefoot, two of finger distal phalanges). Compared to the pre-treatment point, we observed: decrease of the Raynaud's phenomenon VAS (p<0.001), and, in patients with diffuse cutaneous involvement, of the modified Rodnan skin thickness score (p=0.002). The Health Assessment Questionnaire was not significantly improved.


CONCLUSIONS
Treatment with cyclic iloprost can control Raynaud's phenomenon-related symptoms and ischemic ulcers in the large majority of patients with SSc. However, a disease-modifying effect of this therapy could not be demonstrated.
Scarsi
M
M
Servizio di Reumatologia ed Immunologia Clinica, Spedali Civili, Brescia, Italia. scarsi@bresciareumatologia.it
Rossi
M
M
Danieli
E
E
Frigè
A
A
Grottolo
A
A
Zambruni
A
A
Airò
P
P
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000188:drug therapy*; D013997:Time Factors
D016285:Iloprost