[Bosentan for treatment of active digital ulcers in patients with systemic sclerosis].

David Launay 1 Elisabeth Diot Elisabeth Pasquier 2, 3 Luc Mouthon 4, 5 Nadine Boullanger Olivier Fain 6 Patrick Jego 7 Patrick Carpentier 8 Pierre-Yves Hatron 9 Eric Hachulla 10
1 Department of Internal Medicine
2 GETBO - Groupe d'Etude de la Thrombose de Bretagne Occidentale
3 DMIP - Brest - Département de Médecine Interne et Pneumologie [Brest]
4 UM3 (UMR 8104 / U1016) - Institut Cochin
5 EA 4058 - Groupe de recherche sur les maladies systémiques
6 Service de médecine interne
7 Service de médecine interne
8 Clinique de Médecine Vasculaire
9 Service de médecine interne
10 Hôpital Claude Huriez
Abstract : OBJECTIVES: To describe the effect of bosentan and its dual inhibition of endothelin-1 ETA and ETB receptors on digital ulcers in patients with systemic sclerosis (SSc). METHODS: Patients receiving bosentan for SSc-related digital ulcers were identified in eight centers, and their characteristics and follow-up were recorded. RESULTS: Nine (six with diffuse and three with limited cutaneous forms of SSc) patients (median age: 54 years) had received bosentan for digital ulcers. Complete healing occurred in seven (median time to improvement: 4 weeks). Another experienced a significant decrease in the number of ulcers (from 22 to 5) in 8 weeks, while one had no improvement. After a median follow-up of 24.3 months, only one recurrence was observed. Raynaud phenomenon improved in all but one patient. DISCUSSION: These data suggest that some patients may benefit from bosentan to treat digital ulcers. The short time to healing in these patients with rather chronic ulcers argues strongly in favor of its use. These results also strengthen the evidence that endothelin-1 plays an important role in the vascular manifestations of SSc. CONCLUSION: Bosentan can be effective in the treatment of digital ulcers in some SSc patients with SSc, probably especially those involving substantial ischemia. Bosentan is not a first-line drug in this indication yet and must be carefully used by specialists in SSc. Forthcoming results from the international RAPIDS-2 study should clarify the indications for bosentan in the treatment of SSc-related digital ulcers.
Type de document :
Article dans une revue
La Presse medicale, Paris, Masson et Cie, 2006, 35 (4 Pt 1), pp.587-92
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http://hal.univ-brest.fr/hal-00689390
Contributeur : Ghislaine Calvez <>
Soumis le : jeudi 19 avril 2012 - 15:27:17
Dernière modification le : mardi 10 avril 2018 - 13:42:01

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  • HAL Id : hal-00689390, version 1
  • PUBMED : 16614599

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David Launay, Elisabeth Diot, Elisabeth Pasquier, Luc Mouthon, Nadine Boullanger, et al.. [Bosentan for treatment of active digital ulcers in patients with systemic sclerosis].. La Presse medicale, Paris, Masson et Cie, 2006, 35 (4 Pt 1), pp.587-92. 〈hal-00689390〉

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