Longterm Treatment with Endothelin Receptor Antagonist Bosentan and Iloprost Improves Fingertip Blood Perfusion in Systemic Sclerosis

Abstract

Longterm treatment of SSc patients with ET-1 antagonism, in combination with ILO, seems to increase fingertip blood perfusion, as well as both capillary dilation capacity and number.

Effects of Longterm Treatment with Bosentan and Iloprost on Nailfold Absolute Capillary Number, Fingertip Blood Perfusion, and Clinical Status in Systemic Sclerosis

“…The tendency of ΔFBP to increase in the ILO + BOSE group and to decrease in the ILO group confirms the influence exerted by the ERA treatment on microvasculature reactivity as also previously reported 6,16,26 .…”

“…Previous longterm followup studies showed that treatment with BOSE in combination with ILO interferes with the progression of nailfold microvascular damage, but evaluated through less-sensitive methods such as semiquantitative scoring of capillary number by NVC and fingertip blood perfusion (FBP) by LDF 15,16 .…”

Optimized treatment algorithms for digital vasculopathy in SSc

“…9 In 2014, the longterm treatment of patients with SSc who had digital ulcers with ERA plus a vasodilator (iloprost) prevented the progression of microvascular damage as assessed by nailfold videocapillaroscopy and by analysis of peripheral blood flow. 10 This therapeutic approach is also included in the new recommendations. 1 More recent techniques to evaluate local skin blood per fusion, such as laser speckle contrast analysis (LASCA, a noncontact and safe tool already validated in SSc), offer the possibility to evaluate digital ulcer progression during combined treatment with standard systemic therapies and local medications.…”

Effect of treatment with iloprost with or without bosentan on nailfold videocapillaroscopic alterations in patients with systemic sclerosis

“…Several clinical studies suggested that both iloprost and bosentan are able to positively affect the scleroderma [30][31][32]. In 2012 Guiducci et al observed in nine patients with SSc complicated by arterial pulmonary hypertension a change of scleroderma pattern from ''late'' to ''active'' in seven patients after 12 months of treatment with bosentan, while NVC pattern remained unchanged in nine SSc patients treated with iloprost.…”