Iloprost as cyclic five-day infusions in the treatment of scleroderma. An open pilot study in 20 patients treated for one year.

Abstract

OBJECTIVE:

To evaluate the safety and efficacy of cyclic intravenous iloprost therapy in diffuse or limited scleroderma.

METHODS:

Twenty patients, 14 women and 6 men with a mean age of 47.8 +/- 8.2 years, were given iloprost infusions for six hours a day during five consecutive days, at a rate of 0.5 to 2 ng/kg/min. The course was repeated every three months for one year. Efficacy was evaluated based on a scleroderma skin lesion score, an ischemic lesion score, a well-being self-assessment score, and lung function tests including measurement of the diffusing capacity of the lung for carbon monoxide. Safety was assessed based on adverse event collection.

RESULTS:

The scleroderma skin lesion and ischemic lesion scores decreased significantly over the one-year treatment period, from 37.1 +/- 16.5 to 10.2 +/- 6.9 (P < 0.001) and from 31.8 +/- 19.1 to 2.2 +/- 2.0 (P < 0.05), respectively. The well-being self-assessment score also showed a significant improvement, from 71.4 +/- 16.5 to 15.0 +/- 6.6 (P < 0.001). The diffusing capacity for carbon monoxide was decreased in 11 patients at baseline and showed a slight, non significant increase in these patients after the treatment period. No serious or persistent side effects were recorded.

CONCLUSION:

Cyclic intravenous iloprost therapy was associated with improvements in skin changes and in general health, as well as with a slight increase in the diffusing capacity of the lung for carbon monoxide. Our data suggest that iloprost may act on some of the pathogenetic mechanisms of scleroderma in a way that improves the course of the disease.

• Authors: D Biasi, A Carletto, P Caramaschi, S Zeminian, M L Pacor, R Corrocher, L M Bambara
• Journal: Revue du rhumatisme (English ed.) (Rev Rhum Engl Ed) Vol. 65 Issue 12 Pg. 745-50 (Dec 1998) ISSN: 1169-8446 [Print] France
• PMID: 9923042 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Iloprost

Topics

• Female
• Fingers (blood supply)
• Humans
• Iloprost (therapeutic use)
• Infusions, Intravenous
• Lung (drug effects)
• Male
• Microcirculation (drug effects)
• Middle Aged
• Pilot Projects
• Prospective Studies
• Respiratory Function Tests
• Safety
• Scleroderma, Localized (drug therapy)
• Scleroderma, Systemic (drug therapy)
• Skin (drug effects, pathology)
• Toes (blood supply)
• Treatment Outcome