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Digital ulcers in scleroderma patients: A retrospective observational study.
A De Cata1, M Inglese2, F Molinaro2
1Department of Medical Sciences, Division of Internal Medicine and Rheumatology Unit, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy angelo.decata@libero.it.
International Journal of Immunopathology and Pharmacology
|December 20, 2015
Summary
Combination therapy with iloprost and bosentan effectively healed digital ulcers (DUs) in systemic sclerosis (SSc) patients with mild fibrosis. Fibrosis severity significantly impacted healing outcomes, while bosentan prevented new DUs.
Area of Science:
- Rheumatology
- Dermatology
- Vascular Medicine
Background:
- Systemic sclerosis (SSc) guidelines recommend iloprost for wound healing and bosentan for preventing new digital ulcers (DUs).
- The study investigated the efficacy of combining iloprost and bosentan for DU management in SSc patients.
Purpose of the Study:
- To evaluate if combined iloprost and bosentan therapy is more effective than single-drug treatments for DUs in SSc.
- To assess the impact of fibrosis severity on DU healing with combination therapy.
Main Methods:
- Retrospective analysis of 34 SSc patients with active DUs.
- Patients received 6 months of iloprost followed by 6 months of combined iloprost and bosentan therapy.
- Patients were stratified based on digital skin fibrosis severity.
Main Results:
- 49.3% of DUs healed completely, 26.1% partially healed, and 24.6% showed no response.
- No new DUs developed during the combination therapy period.
- Complete healing rates were significantly higher in patients with mild fibrosis (83.4%) compared to severe fibrosis (18%).
Conclusions:
- Combined iloprost and bosentan therapy promotes DU healing in SSc patients, particularly those with mild digital fibrosis.
- Skin fibrosis severity is a critical factor influencing DU healing.
- Bosentan demonstrated efficacy in preventing the onset of new DUs.
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