Oral calcitriol as a new therapeutic modality for generalized morphea

Hulshof, M. M.

doi:10.1001/archderm.130.10.1290

Cited by 14 publications

(8 citation statements)

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“…Another approach is to use calcitriol (vitamin D 3 ) 0.25–0.50 μg twice a day for 6–12 months. Although calcitriol appears to be well tolerated, we have not observed the dramatic improvement described in the original three cases (14).…”

Section: Localized Sclerodermacontrasting

confidence: 66%

Scleroderma

Connolly

2001

Dermatol Ther

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Scleroderma presents a formidable therapeutic challenge for both the physician and the patient. Over the years many medications and interventions have been reported to be beneficial in scleroderma. With equal regularity, however, when put to the test of the randomized controlled trial, many of these same medications have subsequently been shown to be ineffective. This is true for both the localized and systemic forms of the disease. Two of the most recent additions to this inauspicious list for systemic sclerosis include D‐penicillamine and methotrexate. At the very least these outcomes should point to our deficiencies in understanding the pathogenesis of this unusual disorder. It should raise the possibility that collagen and inflammatory or immune cells are not good therapeutic targets and new targets should be sought. Despite the scope of these problems and the lack of definitive therapy, there is a great deal an individual physician can do to help a patient living with scleroderma. This article presents management approaches to patients with either localized or systemic scleroderma.

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Section: Localized Sclerodermacontrasting

confidence: 66%

Scleroderma

Connolly

2001

Dermatol Ther

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“…Oral calcitriol (Rocaltrol®, Roche) was given at a dose of 0.25 μg/day in the first week, according to the protocol described by Hulshof et al. ( 10). This dose was increased every week to reach 0.75 μg/day during the third week.…”

Section: Methodsmentioning

confidence: 99%

“…At present there is no accepted or proved treatment for localized scleroderma. Recently the beneficial effects of 1,25‐dihydroxyvitamin D 3 (calcitriol) were reported in adults ( 8–10). The presence of cutaneous receptors for calcitriol suggested that the skin was not only a site for vitamin D synthesis, but also a target organ for this hormone.…”

mentioning

confidence: 99%

Treatment of Linear Scleroderma with Oral 1,25‐Dihydroxyvitamin D₃ (Calcitriol) in Seven Children

Elst

Suijlekom‐Smit

Oranje

1999

Pediatric Dermatology

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Linear scleroderma is a connective tissue disorder that characteristically involves the skin. Skin induration and pigmentary changes present in a linear distribution. Severe functional and cosmetic disability may occur, especially in growing children. No effective therapy for the fibrotic stage of scleroderma is available at present. Recently a beneficial effect of oral 1,25-dihydroxyvitamin D 3 (calcitriol) treatment was reported in adults. Calcitriol has a dose-dependent inhibition on fibroblast proliferation and collagen synthesis and has immunoregulatory activities. We assessed the efficacy of oral calcitriol treatment in seven pediatric patients with linear scleroderma. During the treatment dietary calcium intake was restricted. Calcium, inorganic phosphate, creatinine, and urea in the serum and urine was monitored. The urinary calcium:creatinine ratio was measured. The effects of the treatment were evaluated using a clinical scoring system. No side effects were observed. Five of the seven patients showed a good to excellent improvement of their lesions. One of them partly relapsed after 19 months, but showed an excellent response to a second therapy session with calcitriol. One patient with rapidly progressive disease failed to respond to therapy. Our results indicate that calcitriol can be an effective agent for treating localized scleroderma in children.

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“…Furthermore, it has been found that in NIH/3T3 fibroblastic cells and primary lung fibroblasts, the expressed functional VDRs and vitamin D opposed the effects of TGF‐β1, a well‐studied profibrotic factor in these cells 13 . Moreover, several studies have demonstrated the effectiveness of orally administered 1,25‐dihydroxycholecalciferol (calcitriol), the biologically active form of vitamin D, as a treatment for scleroderma, a skin fibrosis disease 14–16 . However, relatively little is known about the potential role of vitamin D in this dermal fibrosis formation.…”

mentioning

confidence: 99%