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Treatment of digital ulcers in systemic sclerosis: recent developments and future perspectives
Ioannis Sagonas1, Dimitrios Daoussis2
1Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany.
Clinical Rheumatology
|February 27, 2023
Summary
Digital ulcers (DUs) in systemic sclerosis (SSc) significantly impact quality of life. Promising treatments like prostacyclin analogues and endothelin antagonists offer hope for managing and preventing these painful complications.
Area of Science:
- Rheumatology
- Vascular Medicine
- Dermatology
Background:
- Digital ulcers (DUs) are a primary manifestation of vasculopathy in systemic sclerosis (SSc), leading to significant disability and reduced quality of life.
- Effective management of DUs is crucial for improving patient outcomes in SSc.
Purpose of the Study:
- To review recent literature on the management of digital ulcers in systemic sclerosis.
- To identify current and emerging therapeutic strategies for DUs.
Main Methods:
- A comprehensive literature search was conducted in December 2022 across Web of Science, PubMed, and DOAJ.
- Articles published within the last decade focusing on DU management in SSc were included.
Main Results:
- Prostacyclin analogues, endothelin antagonists, and PDE5 inhibitors show efficacy in treating and preventing DUs, both as monotherapy and in combination.
- Emerging treatments like autologous fat grafting and botulinum toxin injections offer potential for recalcitrant cases.
- Investigational therapies indicate a potential paradigm shift in DU management.
Conclusions:
- Current pharmacotherapies provide significant benefits for DU management in SSc.
- Future research requires well-designed trials to optimize treatment protocols and improve outcomes for patients with SSc-related DUs.
- A combination of advanced vasodilatory drugs and topical treatments may enhance therapeutic efficacy.
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