title: Efficacy of cilostazol for the treatment of Raynaud's phenomenon in systemic sclerosis patients.
abstract: Cilostazol is a selective inhibitor of phosphodiesterase-III with antiplatelet, antithrombotic and vasodilating properties. The aim of our study was to evaluate the effect of the drug on vasculopathy and Raynaud's phenomenon (RP), in a series of patients with systemic sclerosis (SSc), before and after cilostazol treatment. Twenty-one consecutive SSc patients with moderate or severe RP were enrolled in an open-label study. Cilostazol was administered at the dose of 100 mg twice a day, for 12 months. Evaluations included: daily RP attack diary documenting the frequency and duration of RP episodes, Health Assessment Questionnaire-Disability Index, scleroderma visual analogue scales (VAS), flow-mediated dilation and immunological status, including endothelin 1 and interleukin 6 plasma levels. Thirteen patients completed the study. RP duration and daily number episodes recorded over a 3-week period significantly decreased after cilostazol treatment (p = 0.0049 and p = 0.0067, respectively). VAS score indicated a significant amelioration of the patients' perception of RP (p = 0.0117), and both baseline and post-ischemic brachial artery diameters were significantly increased after cilostazol treatment, as compared with basal values (p = 0.0119 and p = 0.0076, respectively). None of the patients developed digital ulcers during the study. A significant clinical improvement of RP was recorded in SSc patients undergoing cilostazol treatment. Study results indicate a potential role of cilostazol as oral maintenance therapy in SSc patients with RP.
authors.affiliation: Department of Internal Medicine, Clinical Immunology Unit, University of Genoa, 16132, Genoa, Italy. negrini@unige.it.|Centre of Excellence for Biomedical Research, University of Genoa, 16132, Genoa, Italy. negrini@unige.it.
authors.forename: Simone
authors.initials: S
authors.lastname: Negrini
authors.affiliation: Department of Internal Medicine, Clinical Immunology Unit, University of Genoa, 16132, Genoa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Spanò
authors.affiliation: Department of Internal Medicine, Clinical Immunology Unit, University of Genoa, 16132, Genoa, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Penza
authors.affiliation: Unit of Cardiovascular Diseases, University of Genoa, 16132, Genoa, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Rollando
authors.affiliation: Department of Internal Medicine, Clinical Immunology Unit, University of Genoa, 16132, Genoa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Indiveri
authors.affiliation: Department of Internal Medicine, Clinical Immunology Unit, University of Genoa, 16132, Genoa, Italy.|Centre of Excellence for Biomedical Research, University of Genoa, 16132, Genoa, Italy.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Filaci
authors.affiliation: Department of Internal Medicine, Clinical Immunology Unit, University of Genoa, 16132, Genoa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Puppo
mesh_terms: D000328:Adult; D000368:Aged; D000077407:Cilostazol; D065187:Controlled Before-After Studies; D006801:Humans; D008875:Middle Aged; D011928:Raynaud Disease / Q000628:therapy*; D012595:Scleroderma, Systemic / Q000150:complications*; D011795:Surveys and Questionnaires; D013777:Tetrazoles / Q000008:administration & dosage*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D013777:Tetrazoles; D014665:Vasodilator Agents; D000077407:Cilostazol
keywords: Cilostazol; Raynaud phenomenon; Scleroderma; Systemic sclerosis