The safety and persistence of intravenous iloprost in systemic sclerosis

Detalhes bibliográficos
Autor(a) principal: Martins, Patrícia
Data de Publicação: 2022
Outros Autores: Dourado, Eduardo, Fonseca, João Eurico, Romão, Vasco C., Resende, Catarina
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10451/58143
Resumo: © Sociedade Portuguesa de Reumatologia
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spelling The safety and persistence of intravenous iloprost in systemic sclerosisScleroderma and related disordersRaynaud’s syndromeIloprost© Sociedade Portuguesa de ReumatologiaIntroduction: Vasculopathy is a crucial feature of systemic sclerosis (SSc). It occurs in almost every patient with SSc, with Raynaud's phenomenon (RP) and digital ulcers (DU) having a great impact on the quality of patients' lives. Intravenous (IV) iloprost, a synthetic analogue of prostacyclin, is broadly used to treat RP and DU secondary to SSc. Currently, there is no standard protocol defined for the iloprost treatment of SSc-associated RP and DU, and, consequently, the management of this treatment is largely based on each centre's experience. Objective: The objective of this study is to evaluate the safety profile of a particular scheme of IV iloprost used in our centre as the standard treatment of SSc-related vascular complications. Methods: We retrospectively evaluated the clinical records of SSc patients, classified according to the 2013 European Alliance of Associations for Rheumatology (EULAR) criteria (31) with SSc-related DU and/or severe RP not responsive to CCB, receiving or who have received IV iloprost infusions from January 1st 2011 to March 31st 2021 Results: Within this time frame, 60 patients (n=44 for DU; n=16 for severe RP) were treated with a monthly 10-hour IV iloprost perfusion with a dosing regimen adapted to individual tolerance. Forty-nine of these 60 patients (81.7%) were on iloprost for more than one year. Within 12 months of therapy, 40 patients have healed the DUs (90.9%), with only 4 patients maintaining active DUs. A significant clinical improvement in RP at 12 months was observed in 87.5% (n=14/16) of SSc patients with severe RP. Eleven AE implying treatment dose/frequency adjustments or suspension were recorded (18.3% of patients): severe headache (n=5), hypotension (n=3), tachycardia (n=1), flushing (n=1) and generalised erythroderma (n=1). In all patients, the perfusion rate was reduced in the following treatment sessions with good tolerance, with the exception of the patient with the generalised erythroderma reaction, who suspended the perfusion and was later switched to bosentan. After a mean follow-up time of 6.9 (+/-) 4.0 years of treatment (range 0.06-22), 24 patients (40%) stopped the therapy, 14 (58.3%) of whom due to clinical improvement. The overall 5-, and 10-year survival rates of IV iloprost were 68.2% and 55.6%, respectively. Conclusion: SSc patients who received this flexible IV iloprost regimen achieved clinical improvement, reflected in the high persistence rate of the drug, with a good tolerability profile. In addition, most side effects were mild and easily managed.Sociedade Portuguesa de ReumatologiaRepositório da Universidade de LisboaMartins, PatríciaDourado, EduardoFonseca, João EuricoRomão, Vasco C.Resende, Catarina2023-06-09T13:56:24Z20222022-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/58143engARP Rheumatol. 2022 Apr-Jun;1(2):122-1282795-4552info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-08T17:06:49Zoai:repositorio.ul.pt:10451/58143Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T22:08:24.847597Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv The safety and persistence of intravenous iloprost in systemic sclerosis
title The safety and persistence of intravenous iloprost in systemic sclerosis
spellingShingle The safety and persistence of intravenous iloprost in systemic sclerosis
Martins, Patrícia
Scleroderma and related disorders
Raynaud’s syndrome
Iloprost
title_short The safety and persistence of intravenous iloprost in systemic sclerosis
title_full The safety and persistence of intravenous iloprost in systemic sclerosis
title_fullStr The safety and persistence of intravenous iloprost in systemic sclerosis
title_full_unstemmed The safety and persistence of intravenous iloprost in systemic sclerosis
title_sort The safety and persistence of intravenous iloprost in systemic sclerosis
author Martins, Patrícia
author_facet Martins, Patrícia
Dourado, Eduardo
Fonseca, João Eurico
Romão, Vasco C.
Resende, Catarina
author_role author
author2 Dourado, Eduardo
Fonseca, João Eurico
Romão, Vasco C.
Resende, Catarina
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Martins, Patrícia
Dourado, Eduardo
Fonseca, João Eurico
Romão, Vasco C.
Resende, Catarina
dc.subject.por.fl_str_mv Scleroderma and related disorders
Raynaud’s syndrome
Iloprost
topic Scleroderma and related disorders
Raynaud’s syndrome
Iloprost
description © Sociedade Portuguesa de Reumatologia
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-01-01T00:00:00Z
2023-06-09T13:56:24Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10451/58143
url http://hdl.handle.net/10451/58143
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv ARP Rheumatol. 2022 Apr-Jun;1(2):122-128
2795-4552
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Reumatologia
publisher.none.fl_str_mv Sociedade Portuguesa de Reumatologia
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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