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ISSN 0210-5187 (Electronic)

2017, Number 1

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Med Cutan Iber Lat Am 2017; 45 (1)

Effect of bosentan on Raynaud phenomenon and digital ulceration in patients with systemic sclerosis

Patiño P, Isernia MC, Guzmán S, Ortiz W, Bell-Smythe A, González N, Frias J, Pérez AR

Language: Spanish
References: 35
Page: 18-24
PDF size: 352.30 Kb.


ABSTRACT

Systemic sclerosis is an autoimmune connective tissue disease characterized by vascular damage, fibrosis and digital vasculopathy. The most common and evident expression is Raynaud’s phenomenon, that leads to digital ulceration. Digital ulcers are reported in 44-60% and are associated with severe pain and disability. Many treatment options are available, without favorable results. Objective: To assess the effect of bosentan on skin fibrosis and the appearance of digital ulcers in patients with scleroderma that presented Raynaud’s phenomenon. Methods: Prospective, open-label trial. A total of 12 patients diagnosed with scleroderma were included in this study. A clinical evaluation was performed with the modified Rodnan skin score, examination of hand function, capillaroscopy, ultrasound of the skin and the visual analog scale to rate their disability related to specific organ systems. They received 62.5 mg of bosentan twice daily for four weeks and then 125 mg twice daily for 26 weeks. To assess the effectiveness and adverse effects, monitoring was performed every eight weeks and at the end of treatment. Results: None of the patients presented new digital ulcers after beginning treatment. There was improvement in skin fibrosis measured by modified Rodnan score and ultrasonography; both variables were statistically significant (p ‹ 0.001). There were also statistically significant changes between baseline and week 30 in the improvement of the disease, measured by the patients with the visual analog scale (VAS). Conclusion: Bosentan may be effective in the treatment of digital vasculopathy, decreasing the appearance of new digital ulcers, reducing skin fibrosis and improving hand function in patients with systemic sclerosis.


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