TREATMENT OF CALCINOSIS WITH DILTIAZEM

Objective, To test the hypothesis that the calcium antagonist diltiaze m is effective in the treatment of calcinosis. Methods. Diltiazem, 240 -480 mg/day, was given to 4 patients with idiopathic or CREST-related (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodacty ly, telangiectasias) calcinosis for 1-12 years, Serial radiographs of the affected areas, using identical technique, and clinical evaluation s were obtained, A fifth patient, who did not tolerate diltiazem, rece ived verapamil, 120 mg/day for 18 months. Results. All patients taking diltiazem had a reduction or disappearance of the calcific lesions, w ith striking clinical improvement, One patient's case was followed for 12 years. The response to diltiazem during the first 5 years of treat ment has been previously reported in detail; however, over 7 years of additional treatment, there was further reduction of the lesions, One patient developed a large calcific lesion while receiving verapamil fo r hypertension, and after verapamil was replaced with diltiazem, there was a dramatic response. Verapamil was ineffective in the fifth patie nt, who did not tolerate diltiazem. Conclusion. Long-term treatment wi th diltiazem, but not verapamil, is effective in calcinosis.