TREATMENT OF ISCHEMIC DIGITAL ULCERS AND PREVENTION OF GANGRENE WITH INTRAVENOUS ILOPROST IN SYSTEMIC-SCLEROSIS

Twelve patients with systemic sclerosis were treated with intravenous infusions of the prostacyclin-stable analogue iloprost 0.5-2.0 ng/kg/m in for 6 h from 8 to 13 days, Imminent gangrene was stopped in 2 patie nts and followed by healing. In 4 of 6 patients iloprost led to comple te healing of ischaemic ulcers and in the remaining 2 patients to part ial healing. One patient with severe Raynaud's phenomenon discontinued the study after 3 days due to severe headache, The 2 remaining patien ts with Raynaud's phenomenon as an indication improved, while no impro vement was recorded in a patient with vasculitis of the lower leg, Sid e-effects such as headache, nausea and flushing were the reason that o nly 5 patients reached the maximum infusion rate, No statistical diffe rences were recorded in digital bloodflow before and after the study o r in plasma endothelin in the 9 patients investigated. Three of the 6 patients with healing ulcers, however, showed a pronounced decrease in plasma endothelin, IIoprost appears useful as a treatment of imminent gangrene and ischaemic ulcers in systemic sclerosis, This reparatory capacity could also be of a more general importance in therapy of this disease.