Lidocaine for systemic sclerosis: a double-blind randomized clinical trial

Area of Science:

• Rheumatology
• Dermatology
• Pharmacology

Background:

• Systemic sclerosis (SSc) is a severe connective tissue disease characterized by excessive collagen deposition.
• Lidocaine's potential to inhibit prolyl hydroxylase, an enzyme crucial for collagen synthesis, suggested a possible therapeutic role.
• This study investigated lidocaine's efficacy for SSc, a condition with high mortality.

Purpose of the Study:

• To evaluate the efficacy and safety of lidocaine in treating systemic sclerosis (SSc).
• To assess lidocaine's impact on skin, esophageal, and microvascular manifestations of SSc.
• To compare lidocaine's effects against a placebo in SSc patients.

Main Methods:

• A randomized, double-blind clinical trial involving 24 SSc patients.
• Patients received intravenous lidocaine or placebo across three cycles.
• Outcomes included modified Rodnan skin score, esophageal manometry, nailfold capillaroscopy, and quality of life assessments.

Main Results:

• No statistically significant differences were observed between lidocaine and placebo groups for any outcome.
• Skin improvement (modified Rodnan score) was seen in 66.7% of placebo and 50% of lidocaine recipients.
• Subjective self-assessment improved similarly in both groups, with no significant difference.

Conclusions:

• Lidocaine, at the tested dosage and administration method, demonstrated a lack of efficacy in treating systemic sclerosis.
• The treatment was found to be safe, with no significant adverse effects reported.
• Further research with different dosages and administration routes is warranted to fully explore lidocaine's potential in SSc.