The treatment with N-acetylcysteine of Raynaud's phenomenon and ischemic ulcers therapy in sclerodermic patients: a prospective observational study of 50 patients.
N-Acetylcysteine is useful in the short-term treatment of severe Raynaud's phenomenon and digital ulcers (DU) in patients with systemic sclerosis (SSc), but its long-term effects are largely unknown. The aim of this study was to report long-term outcome (median follow-up 3 years) in a prospective study of a cohort of 50 consecutive patients with SSc who received N-acetylcysteine (NAC) infusional therapy every 2 weeks. We observed a reduction of DU/patient/year (4.5 +/- 3.1 vs 0.81 +/- 0.79) and DU ulcer visual analog scale (VAS; 6.88 +/- 2.62 vs 3.20 +/- 1.80), a decrease of the Raynaud's phenomenon (RP) number attacks (7.18 +/- 3.87 vs 3 +/- 1.92), and RP VAS (6.24 +/- 1.92 vs 3.62 +/- 1.48). In this study, we did not observe serious adverse events in patients. Minor side effects were flushing (two patients) and headache (one patient). NAC infusion was generally well tolerated, and nobody had to discontinue the treatment. In conclusion, long-term therapy with NAC, in patients with SSc, has a durable effectiveness on ischemic ulcers and Raynaud's phenomenon.
Rosato
Edoardo
E
Clinical Immunology Unit-Scleroderma Center, Department of Clinical Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185 Rome, Italy.
Borghese
Federica
F
Pisarri
Simonetta
S
Salsano
Felice
F
D000111:Acetylcysteine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005385:Fingers; D016166:Free Radical Scavengers / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D007511:Ischemia / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011928:Raynaud Disease / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D012595:Scleroderma, Systemic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D012867:Skin / Q000098:blood supply; D012883:Skin Ulcer / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D016166:Free Radical Scavengers; D000111:Acetylcysteine
Respirology. 2009 Apr;14(3):354-9
19341424
J Rheumatol. 2007 Dec;34(12):2423-30
17985402
N Engl J Med. 2005 Nov 24;353(21):2229-42
16306520
Arthritis Rheum. 2002 Sep;46(9):2410-20
12355489
Curr Opin Rheumatol. 2007 Nov;19(6):611-8
17917543
J Am Soc Nephrol. 2004 Feb;15(2):251-60
14747371
Joint Bone Spine. 2007 Jan;74(1):e1-8
17218139
Int J Immunopathol Pharmacol. 2005 Oct-Dec;18(4):761-70
16388726
Arthritis Rheum. 2004 Dec;50(12):3985-93
15593188
J Rheumatol. 2001 Oct;28(10):2257-62
11669166
Rheumatology (Oxford). 2005 May;44(5):587-96
15741200
J Rheumatol. 1988 Feb;15(2):202-5
3361530
Am J Respir Crit Care Med. 1997 Dec;156(6):1897-901
9412572
Diabetes Care. 2008 May;31(5):940-4
18268065
Int J Cardiol. 1992 Apr;35(1):116-8
1563867
Mech Ageing Dev. 2008 May;129(5):261-70
18302967
Blood Purif. 2007;25(4):309-15
17643057
Autoimmun Rev. 2007 Sep;6(8):520-3
17854742
J Rheumatol. 1998 Feb;25(2):314-7
9489825
J Rheumatol. 1992 Sep;19(9):1407-14
1279170
Semin Arthritis Rheum. 1975 May;4(4):351-68
1135634
Arthritis Rheum. 1980 May;23(5):581-90
7378088
J Biol Chem. 2002 Feb 1;277(5):3101-8
11719508
J Hypertens. 2006 Nov;24(11):2263-70
17053549
Int J Immunopathol Pharmacol. 2008 Jul-Sep;21(3):679-86
18831936