Contemporary management of Raynaud's phenomenon and digital ischaemic complications

Herrick, Ariane L.

doi:10.1097/bor.0b013e32834aa40b

Cited by 56 publications

(38 citation statements)

References 40 publications

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“…The clinical analysis over 4 years confirmed the efficacy of BOSE in preventing new DU, which in turn are known to correlate with nailfold capillary number 5,11,25,27,28,29 .…”

Section: Discussionmentioning

confidence: 83%

“…In particular, for severe RP and for prevention of DU onset and treatment of PAH, both intravenous (IV) prostanoid iloprost (ILO) and the dual endothelin-1 receptor antagonist (ERA) bosentan (BOSE) are used, respectively 10 . BOSE seems to block pathogenic activities of endothelin-1, the endothelial-derived mediator determining both vasoconstriction and fibrosis genes induction 11,12,13,14 .…”

Section: Rheumatologymentioning

confidence: 99%

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Effects of Longterm Treatment with Bosentan and Iloprost on Nailfold Absolute Capillary Number, Fingertip Blood Perfusion, and Clinical Status in Systemic Sclerosis

Trombetta

Pizzorni²,

Ruaro³

et al. 2016

J Rheumatol

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Objective.To quantify in patients with systemic sclerosis (SSc) the absolute nailfold capillary number/mm (the absolute number of capillaries, observable in the first row, in 1 mm per field) and fingertip blood perfusion (FBP) during longterm therapy with the endothelin receptor antagonist bosentan (BOSE) and the synthetic analog of prostacyclin PGI2 iloprost (ILO) by multiple diagnostic tools. Observed values were correlated with clinical outcomes.Methods.Thirty patients with SSc already receiving intravenous ILO (80 μg/day) for 5 continuous days (every 3 mos) were recruited in the clinic. Fifteen patients continued such treatment (ILO group), while in 15 patients BOSE (125 mg twice/day) was added (ILO + BOSE group) because of the onset of pulmonary arterial hypertension or digital ulcers (DU). The followup period was 4 years (T0–T4). Every year the following were evaluated: absolute nailfold capillary number/mm by nailfold videocapillaroscopy, FBP by laser Doppler flowmetry, DU incidence, DLCO, systolic pulmonary arterial pressure (sPAP), renal arterial resistive index, and other biomarkers. From T2 to T4, laser speckled contrast analysis was added. Nonparametric tests were used for statistical analysis.Results.Limited to the ILO + BOSE group, absolute capillary number/mm and FBP showed a progressive increase independently from other variables. In addition, during followup there was a significant reduction (80%) in the incidence of new DU, whereas DLCO and sPAP did not worsen.Conclusion.The study shows in patients with SSc with up to 4 years of combined therapy a progressive significant recovery in structure and function of microvasculature linked to improved clinical outcomes, independent of disease severity.

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“…The clinical analysis over 4 years confirmed the efficacy of BOSE in preventing new DU, which in turn are known to correlate with nailfold capillary number 5,11,25,27,28,29 .…”

Section: Discussionmentioning

confidence: 83%

Section: Rheumatologymentioning

confidence: 99%

Effects of Longterm Treatment with Bosentan and Iloprost on Nailfold Absolute Capillary Number, Fingertip Blood Perfusion, and Clinical Status in Systemic Sclerosis

Trombetta

Pizzorni²,

Ruaro³

et al. 2016

J Rheumatol

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“…Ezáltal előtérbe került az endothelinreceptor-antagonisták (bosentan) tanulmá-nyozása, főleg az ujjak fekélyképződésével járó kórál-lapot esetén [23].…”

Section: Alfa-adrenerg-blokkolókunclassified

Raynaud’s syndrome, 2011

Takáts

Garai²,

Papp

et al. 2012

Orvosi Hetilap

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Raynaud’s phenomenon is characterized by intense vasospasm of the digital arteries on cold exposure or emotional stress, leading to well-defined colour changes in the skin of the fingers. Behind the clinical manifestations, there is an imbalance between vasoconstrictor and vasodilator factors. It may be primary or secondary to an underlying condition, including autoimmune diseases. Physical examination, nail fold capillaroscopy and immunological tests can differentiate primary forms from secondary ones. The treatment is based on preventing exposure to cold, emotional stress and the administration of certain drugs and, if attacks are present, vasodilators, prostaglandin analogues and anticoagulants may be given. This review focuses on the characteristics of Raynaud’s phenomenon and the available diagnostic and therapeutic options. Orv. Hetil., 2012, 153, 403–409.

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“…The system thus combines the flexibility of a hand-held capillaroscopy device with the advantages of a rigid platform for obtaining high-quality images 1 .…”

Section: A New High Frame Rate Capillaroscopy Systemmentioning

confidence: 99%

“…In particular, NC can identify the characteristic structural changes in capillaries that differentiate patients with symptoms of SSc induced Raynauds phenomenon (RP; the most common presenting feature of SSc) from those with the more common and relatively benign primary (idiopathic) RP (PRP) [1,2].…”

Section: Introductionmentioning

confidence: 99%

Improved Diagnosis of Systemic Sclerosis Using Nailfold Capillary Flow

Berks

Dinsdale

Murray

et al. 2016

Lecture Notes in Computer Science

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Abstract. Nailfold capillaroscopy (NC) allows non-invasive imaging of systemic sclerosis (SSc) related microvascular disease. We have developed a state-of-theart NC system that enables fast, panoramic imaging of the whole nailfold at highmagnification, and incorporates novel software to make fully automated estimates of capillary structure and blood flow velocity. We present the first results of a study in which 50 patients with SSc, 12 with primary Raynauds phenomenon (PRP) and 50 healthy controls (HC) were imaged using the new system, and show that a combined model of capillary measurements strongly separates SSc from HC/PRP (ROC Az=0.93). Including capillary flow improves model performance, suggesting flow provides complementary information to capillary structure for diagnosing SSc.

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Contemporary management of Raynaud's phenomenon and digital ischaemic complications

Cited by 56 publications

References 40 publications

Effects of Longterm Treatment with Bosentan and Iloprost on Nailfold Absolute Capillary Number, Fingertip Blood Perfusion, and Clinical Status in Systemic Sclerosis

Effects of Longterm Treatment with Bosentan and Iloprost on Nailfold Absolute Capillary Number, Fingertip Blood Perfusion, and Clinical Status in Systemic Sclerosis

Raynaud’s syndrome, 2011

Improved Diagnosis of Systemic Sclerosis Using Nailfold Capillary Flow

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