Effect of treatment with iloprost with or without bosentan on nailfold videocapillaroscopic alterations in patients with systemic sclerosis
| Autor: | Clodoveo Ferri, Emanuela Praino, F. Cannarile, Marco Sebastiani, Dilia Giuggioli, Valentina Cestelli, Andreina Teresa Manfredi |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Combination therapy Bosentan CSURI Iloprost Microangiopathy Systemic sclerosis Videocapillaroscopy Rheumatology 030204 cardiovascular system & hematology Gastroenterology Scleroderma Microscopic Angioscopy 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans skin and connective tissue diseases Antihypertensive Agents Aged 030203 arthritis & rheumatology Sulfonamides Scleroderma Systemic integumentary system business.industry Raynaud Disease Middle Aged Skin ulcer medicine.disease Capillaries Surgery Treatment Outcome Drug Therapy Combination Female medicine.symptom Endothelin receptor business medicine.drug |
| Popis: | Vascular involvement plays a decisive role in systemic sclerosis (SSc) pathogenesis; it is responsible for some important clinical manifestations of the disease such as Raynaud's phenomenon and digital ulcers (DU). Bosentan, a dual receptor endothelin antagonist, and iloprost, often in combination therapy, seems to be able to interfere with the scleroderma microangiopathy.Aim of the study was to evaluate the effect of bosentan and iloprost on scleroderma microangiopathy, analyzed by means of capillaroscopic skin ulcer risk index (CSURI), in SSc patients treated for the prevention of DU.Nailfold videocapillaroscopy (NVC) was performed in 95 SSc patients, treated with iloprost alone (group 1) or combination therapy with iloprost and bosentan (group 2), at baseline and after one year. In all patients CSURI was calculated according to the formula "diameter × number of megacapillaries/(total number of capillaries)After 12 months, we observed a reduction of the number of giant capillaries in both groups, while an increase of ramified capillaries was recorded only in group 2. CSURI improved slightly in group 2 without statistical significance; on the contrary, in group 1 a significant worsening was recorded (p ≤ 0.001).Our study confirms the effectiveness of bosentan, in combination with iloprost, in SSc microangiopathy observed to NVC. Moreover, the observed findings further support the role of CSURI in the evaluation and monitoring of SSc microangiopathy. |
| Databáze: | OpenAIRE |
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