Cyclophosphamide treatment improves microvessel damage in systemic sclerosis.
The objective of this study is to evaluate nailfold videocapillaroscopy changes in scleroderma patients treated regularly on cyclic basis with iloprost and to find associations with clinical, serologic, and pharmacological variables. Forty-nine patients affected by systemic sclerosis (44 women and five men, mean age 52.4 years, mean disease duration 8.0 years, 31 patients with limited cutaneous subset and 18 with diffuse cutaneous form of the disease) underwent two nailfold videocapillaroscopies at a distance of 3 years from each other; the examinations were performed by an operator blinded to clinical features and to drug treatment. Six patients showed an amelioration of nailfold videocapillaroscopic abnormalities who changed from active to early pattern; five of these cases (83.3%) had been given cyclophosphamide therapy and the remaining case methotrexate plus azathioprine. Cyclophosphamide administration was significantly associated with amelioration of nailfold videocapillaroscopic pattern (p<0.001). None of the patients who received cyclophosphamide demonstrated worsening of the microvascular lesions; the progression of nailfold videocapillaroscopic pattern was inversely correlated to cyclophosphamide treatment (p=0.02). In our study, cyclophosphamide treatment demonstrated to be effective for scleroderma microvascular damage as directly observed by nailfold videocapillaroscopy.
Caramaschi
Paola
P
Dipartimento di Medicina Clinica e Sperimentale, Università di Verona, Policlinico G.B. Rossi, Piazzale Scuro, 37134 Verona, Italy. paola.caramaschi@azosp.vr.it
Volpe
Alessandro
A
Pieropan
Sara
S
Tinazzi
Ilaria
I
Mahamid
Helal
H
Bambara
Lisa Maria
LM
Biasi
Domenico
D
D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007107:Immune System; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007249:Inflammation; D008297:Male; D008833:Microcirculation; D055806:Microvessels / Q000293:injuries / Q000503:physiopathology*; D008875:Middle Aged; D010641:Phenotype; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000188:drug therapy* / Q000503:physiopathology*
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D001379:Azathioprine