Iloprost, an intravenous drug used to treat secondary Raynaud’s phenomenon, may stop the development of finger ulcers, protect against heart and lung disease, and prevent disease worsening in systemic sclerosis patients, according to a study published in the journal Rheumatology International.
Systemic sclerosis is a treatable disease, but can have a poor outcome due to associated heart and lung complications. For this reason, stabilizing disease progression — ideally through early diagnosis — is of considerable importance.
Raynaud’s phenomenon is an early symptom of systemic sclerosis, and may precede other clinical signs by many years. The study, “Long-term clinical stabilization of scleroderma patients treated with a chronic and intensive IV iloprost regimen,” shows that iloprost — used for secondary Raynaud’s phenomenon, a more serious form linked to underlying conditions like scleroderma and lupus, as opposed to idiopathic or primary Raynaud’s — may help systemic sclerosis patients realize a more favorable disease course in the long-term.
To evaluate sclerosis progression in patients treated with iloprost, researchers led by Dr. Marcella Di Gangi of Policlinico Vittorio Emanuele in Catania, Italy, enrolled 68 people. All had been treated with iloprost for an average of seven years, with a schedule of five to six consecutive daily infusions per month.
Researchers assessed the modified Rodnan skin score, which measures the extent and severity of skin thickening, as well as lung and heart involvement in the scleroderma patients, using parameters such as systolic pulmonary arterial pressure (a measure of pulmonary hypertension), and tricuspid annular plane systolic excursion and pro-brain natriuretic peptide (two independent measures of heart function) before and after iloprost treatment.
They found a statistically significant improvement in all parameters. The modified Rodnan skin score decreased on average from 4.7 to 3.7, systolic pulmonary arterial pressure also decreased from 30.9 to 24, while tricuspid annular plane systolic excursion increased from 22.1 to 23.8. Finally, pro-brain natriuretic peptide levels decreased from 97.2 to 65.8.
In addition, the number of patients with finger ulcers dropped after treatment with iloprost, and no patients without finger ulcers at the study’s start developed any throughout the study period.
The researchers concluded that an intensive and continuing iloprost infusion regimen stabilizes and may even improve long-term outcomes in systemic sclerosis. “Our results confirm that monthly iloprost infusions for six consecutive days might exert a beneficial healing effect,” they wrote.
Ventavis (iloprost) inhaled solution is used to treat certain kinds of pulmonary arterial hypertension (high blood pressure in the vessels carrying blood to the lungs), and belongs to a class of medications called vasodilators.