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[Digital ulcers in systemic sclerosis : A retrospective heath service study analysing treatment with bosentan and

G Riemekasten1, S Beissert2, J H W Distler3

  • 1Campus Lübeck, Klinik für Rheumatologie, Universitätsklinikum Schleswig-Holstein, Zentralklinikum (Haus 40), Ratzeburger Allee 160, 23538, Lübeck, Deutschland. gabriela.riemekasten@uksh.de.

Zeitschrift Fur Rheumatologie
|August 19, 2016
PubMed

Insights

Systemic sclerosis (SSc) patients often develop digital ulcers (DU). Bosentan effectively prevents new digital ulcers and shortens acute phases, though current therapy guidelines are not fully implemented in practice.

Area of Science:

  • Rheumatology
  • Dermatology
  • Vascular Medicine

Background:

  • Digital ulcers (DU) affect up to 60% of systemic sclerosis (SSc) patients, significantly impacting quality of life and morbidity.
  • Current utilization of authorized medicines and adherence to therapy guidelines for SSc-associated DU remain unclear.

Purpose of the Study:

  • To investigate current treatment standards for the therapy and prevention of SSc-associated DU.
  • To analyze the effect of DU treatment on disease progression.

Main Methods:

  • A retrospective healthcare study involving an online survey of 83 physicians.
  • Analysis of 161 case studies of SSc patients with DU.

Main Results:

  • Physicians commonly prescribed topical therapies, calcium channel blockers, iloprost, and endothelin receptor antagonists for active DU.
  • Bosentan and iloprost were used in 90% of acute DU episodes.
  • Preventive treatment for DU was administered in only 50% of DU-free episodes.
  • Bosentan, used in 57% of DU-free episodes for prevention, shortened subsequent acute phases by 32% and increased time to new DU onset by 16%.

Conclusions:

  • Bosentan demonstrates efficacy in preventing new digital ulcers in DU-free episodes and potentially during acute phases.
  • Therapy recommendations for DU treatment are not consistently implemented in clinical practice.
  • Increased attention to digital ulcer management in systemic sclerosis is warranted.
Abstract

Keywords:
BosentanDigital ulcersHealth services researchSystemic sclerosisVasoactive therapies

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