title: Effects of bosentan on nondigital ulcers in patients with systemic sclerosis.
abstract: BACKGROUND
  Bosentan is an oral dual endothelin receptor antagonist, which has been shown to be efficacious for preventing new digital ulcers in patients with systemic sclerosis (SSc) in two high-quality randomized controlled trials. However, its efficacy for nondigital ulcers in SSc remains unknown.
  
  
  OBJECTIVE
  To evaluate the efficacy of bosentan on nondigital ulcers in patients with SSc.
  
  
  METHODS
  Bosentan was administered to five patients with SSc with pulmonary arterial hypertension, who also had nondigital ulcers refractory to conventional treatments. The efficacy of bosentan on nondigital ulcers and its association with clinical features of ulcers were analysed.
  
  
  RESULTS
  The nondigital ulcers refractory to conventional treatments were significantly improved by the administration of bosentan in cases surrounded with severe cyanosis. In contrast, nondigital ulcers without cyanosis were still refractory to bosentan therapy.
  
  
  CONCLUSIONS
  Bosentan may be efficacious for accelerating the healing of nondigital ulcers with severe cyanosis, suggesting that nondigital ulcers caused by severely impaired peripheral circulation are highly responsive to this treatment.
authors.affiliation: Departments of Dermatology and Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Asano
authors.forename: M
authors.initials: M
authors.lastname: Hatano
authors.forename: Z
authors.initials: Z
authors.lastname: Tamaki
authors.forename: M
authors.initials: M
authors.lastname: Tomita
authors.forename: T
authors.initials: T
authors.lastname: Kawashima
authors.forename: M
authors.initials: M
authors.lastname: Miyazaki
authors.forename: H
authors.initials: H
authors.lastname: Sumida
authors.forename: K
authors.initials: K
authors.lastname: Akamata
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: Y
authors.initials: Y
authors.lastname: Ichimura
authors.forename: T
authors.initials: T
authors.lastname: Toyama
authors.forename: M
authors.initials: M
authors.lastname: Sugita
authors.forename: S
authors.initials: S
authors.lastname: Noda
authors.forename: A
authors.initials: A
authors.lastname: Yao
authors.forename: K
authors.initials: K
authors.lastname: Kinugawa
authors.forename: S
authors.initials: S
authors.lastname: Sato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000077300:Bosentan; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D016523:Foot Ulcer / Q000188:drug therapy*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy; D008875:Middle Aged; D056687:Off-Label Use; D012595:Scleroderma, Systemic / Q000150:complications*; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000959:Antihypertensive Agents; D003879:Dermatologic Agents; D013449:Sulfonamides; D000077300:Bosentan