EFFECTS OF 5-DAY VERSUS ONE-DAY INFUSION OF ILOPROST ON THE PERIPHERAL MICROCIRCULATION IN PATIENTS WITH SYSTEMIC-SCLEROSIS

Objective. To evaluate the effects of iloprost infusion on the microci rculation inpatients suffering from severe Raynaud's phenomenon second ary to systemic sclerosis. Methods. Eight patients received a 7-hour i nfusion of iloprost for five consecutive days and then for one day 3 m onths later: The effects on vascular distensibility were evaluated by piezoelectric plethysmography before and after the treatment and at 2, 4 and 6 weeks. Results. The beneficial effects on the peripheral micr ocirculation were statistically significant after five days of infusio n (distensibility index: 0.18 +/- 0.01 vs 0.23 +/- 0.01, p < 0.002) an d lasted for less than four weeks, whereas no difference (0.22 +/- 0.0 4 vs 0.24 +/- 0.02, p: ns) was seen after one day of treatment. One pa tient suffered from typical angina pectoris with electrocardiographic changes of the ST wave detected during the infusion. Conclusion. Our r esults show that a five-day infusion of iloprost has an effect which l asts from two to four weeks; after foul weeks the distensibility index returned to the baseline value. The one-day infusion had no effect on the vascular bed studied by the piezoelectric pletysmographic method. Treatment with five consecutive days of infusion every four weeks is an impracticable scheme to adopt, however: We have therefore institute d a treatment schedule of a single daily infusion every four weeks wit h the aim of maintaining the effects induced by the initial five-day i nfusion. The preliminary results obtained with this schedule are repor ted.