Comparison between iloprost and alprostadil in the treatment of Raynaud's phenomenon

Scandinavian Journal of Rheumatology
B MarasiniC Maioli

Abstract

The prostanoids iloprost and alprostadil are widely used to treat ischaemic changes in patients with Raynaud's phenomenon (RP), but the optimal regimen is poorly defined. We evaluated whether there are differences between iloprost and alprostadil, in terms of either clinical efficacy or of laboratory data, with the aim of assisting in the treatment of connective tissue disease (CTD)-associated RP. Twenty-one women with CTD-associated RP were given intravenous iloprost (11 patients) or alprostadil (10 patients) cyclically (5 consecutive days, followed by 1 day every 30 days). Clinical efficacy (RP symptoms, skin score, digital ulcers) and circulating levels of von Willebrand factor (VWf), tissue plasminogen activator (tPA), thrombomodulin (TM) and Type III procollagen N-terminal propeptide (PIIINP) were evaluated by enzyme-linked immunoassay at different intervals. The overall benefits of iloprost and alprostadil were similar. RP improved in 45% versus 90% of patients; ulcers in 60% versus 40% of patients (iloprost versus alprostadil). Skin score did not significantly change with either drug. Circulating VWf decreased with either drug (iloprost -6.2%, alprostadil -9.4%), while tPA, TM, and PIIINP remained unchanged. Side effects...Continue Reading

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Citations

Oct 7, 2008·Arthritis Research & Therapy·Marcus JägerRüdiger Krauspe
Mar 20, 2012·Best Practice & Research. Clinical Rheumatology·Oscar-Danilo Ortega-Hernandez, Yehuda Shoenfeld
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Nov 30, 2019·ACR Open Rheumatology·Soumya Chatterjee
Oct 15, 2005·Current Opinion in Rheumatology·Francesco Boin, Fredrick M Wigley
Jan 1, 2010·International Journal of Clinical Rheumatology·Zsuzsanna H McMahan, Fredrick M Wigley
May 18, 2021·The Cochrane Database of Systematic Reviews·Kevin Yc SuJennifer Hwee Kwoon Ng

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