title: Effect of sildenafil on digital ulcers in systemic sclerosis: analysis from a single centre pilot study.
abstract: OBJECTIVE
  In this pilot study, the effect of sildenafil on digital ulcer (DU) healing and related clinical symptoms was analysed.
  
  
  METHODS
  A total of 19 patients with systemic sclerosis (SSc) were treated with maximally tolerated sildenafil doses up to 6 months. Primary outcome was the healing of DUs. Changes in other clinical symptoms were also evaluated.
  
  
  RESULTS
  In all, 49 DUs were present at baseline; this decreased to 17 ulcers (p<0.001) at the end of sildenafil treatment. Furthermore, the visual analogue scale (VAS) score for Raynaud's phenomenon (RP), pain and activity improved (p=0.003, p=0.002 and p=0.05, respectively). A total of 9 patients developed 12 new DUs during sildenafil treatment.
  
  
  CONCLUSIONS
  This study indicates an effect of sildenafil on DU healing in patients with SSc and an improvement of RP and associated symptoms that should be validated in controlled studies.
authors.affiliation: Clinic of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, Germany.
authors.forename: Claudia S
authors.initials: CS
authors.lastname: Brueckner
authors.forename: Mike O
authors.initials: MO
authors.lastname: Becker
authors.forename: Thomas
authors.initials: T
authors.lastname: Kroencke
authors.forename: Doerte
authors.initials: D
authors.lastname: Huscher
authors.forename: Hans Ulrich
authors.initials: HU
authors.lastname: Scherer
authors.forename: Margitta
authors.initials: M
authors.lastname: Worm
authors.forename: Gerd
authors.initials: G
authors.lastname: Burmester
authors.forename: Gabriela
authors.initials: G
authors.lastname: Riemekasten
mesh_terms: D000328:Adult; D000368:Aged; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005385:Fingers; D006229:Hand Dermatoses / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors; D010865:Pilot Projects; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines / Q000627:therapeutic use; D012595:Scleroderma, Systemic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D000068677:Sildenafil Citrate; D012883:Skin Ulcer / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D013450:Sulfones / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate