Circadian variations of plasma levels of blood coagulation/fibrinolysis molecular markers in progressive systemic sclerosis (PSS)

Maeda, Manabu; Kachi, Hideki; Kitajima, Yasuo

doi:10.1016/0923-1811(95)00484-x

Cited by 8 publications

(11 citation statements)

References 24 publications

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“…A wide range of values for these markers in this study and in others (19,27) makes the interpretation of changes in serum levels difficult. Disease subsets in the SSc group (29)(30)(31), baseline disease activity (27,28,31), and reported circadian variation in the serum levels of some markers (32,33) should be also taken into account.…”

Section: Discussionmentioning

confidence: 99%

Losartan therapy for Raynaud's phenomenon and scleroderma: Clinical and biochemical findings in a fifteen-week, randomized, parallel-group, controlled trial

Dziadzio

Denton

Smith

et al. 1999

Arthritis & Rheumatism

277

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Objective. To compare the efficacy and tolerability of losartan, an antagonist of angiotensin II receptor type 1, with nifedipine for the treatment of primary and secondary Raynaud's phenomenon (RP) in a pilot study.Methods. In a randomized, parallel-group, controlled trial, patients with primary RP (n ‫؍‬ 25) or RP secondary to systemic sclerosis (SSc [scleroderma]; n ‫؍‬ 27) were allocated to receive 12 weeks' treatment with either losartan (50 mg/day) or nifedipine (40 mg/day). Primary outcome variables were the severity and frequency of RP episodes and findings on vascular measurements, including thermography and laser Doppler flowmetry. Serum levels of soluble adhesion molecules, endothelin 1, fibrinogen, von Willebrand factor, and procollagen type I N-terminal propeptide (PINP) were also measured.Results. There was a reduction in the severity of RP episodes following treatment with losartan and with nifedipine, but this effect was greater in the losartan arm of the study (P < 0.05): episode frequency was reduced only in the losartan group (P < 0.01 versus baseline). Symptomatic improvement was associated with a significant reduction in soluble vascular cell adhesion molecule 1 and PINP (P < 0.01). Subgroup analysis suggested that although these biochemical changes occurred mainly in SSc patients, the clinical benefit was greater in the primary RP group.Conclusion. This study confirms the tolerability of short-term treatment of RP with losartan, and our data suggest its clinical benefit. Further evaluation of this drug as a long-term treatment for SSc-associated RP should be considered, since it may have additional disease-modifying potential.Episodic digital ischemia provoked by cold and emotion was first described by Maurice Raynaud over 130 years ago (1). When it occurs in isolation, it is designated primary Raynaud's phenomenon (RP) to distinguish it from those cases in which there is an underlying or associated pathology. It affects ϳ10% of the adult population, with a predilection for females, and up to 5% of patients presenting with this condition later develop an autoimmune rheumatic disorder, such as systemic sclerosis (SSc; scleroderma) (2). Successful treatment is often difficult, and although clinical trials suggest that vasodilators can be effective, the responses of individual patients to a particular agent are often idiosyncratic.The pathogenesis of the vascular dysfunction underlying RP is incompletely understood, and relatively few well-controlled clinical trials with vasoactive drugs have been undertaken. Lack of distinction between primary and secondary RP in some of these studies makes their interpretation difficult. Calcium channel antagonists such as nifedipine have been shown to be effective (3-6), although striking differences in individual responses have been described (3,7). Moreover, efficacy is often particularly limited in patients with RP

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Section: Discussionmentioning

confidence: 99%

Losartan therapy for Raynaud's phenomenon and scleroderma: Clinical and biochemical findings in a fifteen-week, randomized, parallel-group, controlled trial

Dziadzio

Denton

Smith

et al. 1999

Arthritis & Rheumatism

277

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“…Design In total, 17 controlled clinical trials [23,26–41], seven cross‐sectional studies [25,42–47] and 13 drug‐intervention studies were included [44,48–59]. One paper incorporated both a cross‐sectional and a drug‐interventional design [44].…”

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confidence: 99%

“…Participants Twelve trials investigated healthy subjects [26–31,33,34,36,38–40] and four trials included patients undergoing surgery [23,32,35,37]. Seven papers studied patients with giant cell arteritis or polymyalgia rheumatica [44,48,50,51,54,58,59], three papers included patients with systemic lupus erythematosus [42,43,52], three investigated heart or renal transplant recipients [25,41,57] and another three studied patients with collagen disease [45,46,56]. The four remaining studies included patients with sepsis syndrome [47], Crohn’s disease [53], Henoch Schönlein [55] or other chronic inflammatory diseases [49].…”

mentioning

confidence: 99%

“…Four cross‐sectional studies compared patients using glucocorticoids with those not treated with glucocorticoids [25,43,45,47]. Two cross‐sectional studies contrasted patients using glucocorticoids and healthy controls [42,44], and one used glucocorticoid‐free patients as well as healthy subjects as a comparison [46]. All but one drug‐intervention study used pre‐glucocorticoid levels as a control situation; the remaining one used levels after glucocorticoid withdrawal as a comparison [57].…”

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confidence: 99%

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Systematic review on the effect of glucocorticoid use on procoagulant, anti‐coagulant and fibrinolytic factors

Zaane

Nur

Squizzato

et al. 2010

Journal of Thrombosis and Haemostasis

171

131

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To cite this article: van Zaane B, Nur E, Squizzato A, Gerdes VEA, Bü ller HR, Dekkers OM, Brandjes DPM. Systematic review on the effect of glucocorticoid use on procoagulant, anti-coagulant and fibrinolytic factors. J Thromb Haemost 2010; 8: 2483-93.Summary. Background: Whether glucocorticoid use contributes to a hypercoagulable state, and thereby enhances the thrombotic risk, is controversial. Objective: We aimed to examine the effects of glucocorticoid use on coagulation and fibrinolysis. Methods: MEDLINE and EMBASE databases were searched to identify published studies comparing glucocorticoid treatment with a glucocorticoid-free control situation. Subjects could be either patients or healthy volunteers. Two investigators independently performed study selection and data extraction. Results were expressed as standardized mean difference, if possible; data were pooled with a random-effects model. Results: Of the 1967 identified publications, 36 papers were included. In healthy volunteers, a clear rise in factor (F)VII, VIII and XI activity was observed after glucocorticoid treatment, but these data alone provided insufficient evidence to support hypercoagulability. However, during active inflammation, glucocorticoids significantly increased levels of plasminogen activator inhibitor-1 (PAI-1), whereas levels of von Willebrand factor (VWF) and fibrinogen decreased. Perioperative use of glucocorticoids inhibited the increase in tissue-type plasminogen activator induced by surgery. Conclusions: The present study showed differential effects of glucocorticoids depending on the clinical situation in which it is given, most likely as a result of their disease modifying properties. Clinical outcome studies are needed to adequately assess the risk-benefit of glucocorticoid use per population when thrombotic complication is the focus.

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“…Maeda et al . reported hypercoagulation with hypofibrinolysis in the haemostasis of patients with SSc 22 . It is also speculated that both sclerosing panniculitis and this hypercoagulation condition are essential for the occurrence of PH in SSc.…”

Section: Discussionmentioning

confidence: 99%

Sclerosing panniculitis is associated with pulmonary hypertension in systemic sclerosis

Jinnin

Ihn

Asano

et al. 2005

British Journal of Dermatology

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Circadian variations of plasma levels of blood coagulation/fibrinolysis molecular markers in progressive systemic sclerosis (PSS)

Cited by 8 publications

References 24 publications

Losartan therapy for Raynaud's phenomenon and scleroderma: Clinical and biochemical findings in a fifteen-week, randomized, parallel-group, controlled trial

Losartan therapy for Raynaud's phenomenon and scleroderma: Clinical and biochemical findings in a fifteen-week, randomized, parallel-group, controlled trial

Systematic review on the effect of glucocorticoid use on procoagulant, anti‐coagulant and fibrinolytic factors

Sclerosing panniculitis is associated with pulmonary hypertension in systemic sclerosis

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