Departments of Dermatology and Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Br J Dermatol. 2012 Feb;166(2):417-21. doi: 10.1111/j.1365-2133.2011.10581.x. Epub 2011 Dec 5.
Bosentan is an oral dual endothelin receptor antagonist, which has been shown to be efficacious for preventing new digital ulcers in patients with systemic sclerosis (SSc) in two high-quality randomized controlled trials. However, its efficacy for nondigital ulcers in SSc remains unknown.
To evaluate the efficacy of bosentan on nondigital ulcers in patients with SSc.
Bosentan was administered to five patients with SSc with pulmonary arterial hypertension, who also had nondigital ulcers refractory to conventional treatments. The efficacy of bosentan on nondigital ulcers and its association with clinical features of ulcers were analysed.
The nondigital ulcers refractory to conventional treatments were significantly improved by the administration of bosentan in cases surrounded with severe cyanosis. In contrast, nondigital ulcers without cyanosis were still refractory to bosentan therapy.
Bosentan may be efficacious for accelerating the healing of nondigital ulcers with severe cyanosis, suggesting that nondigital ulcers caused by severely impaired peripheral circulation are highly responsive to this treatment.
波生坦是一种口服双重内皮素受体拮抗剂，两项高质量的随机对照试验已证明其可有效预防系统性硬皮病（SSc）患者新发的指端溃疡。然而，其在 SSc 患者中非指端溃疡的疗效尚不清楚。
评估波生坦治疗系统性硬皮病非指端溃疡的疗效。
对 5 例患有肺动脉高压的 SSc 患者给予波生坦治疗，这些患者还患有对常规治疗无反应的非指端溃疡。分析了波生坦对非指端溃疡的疗效及其与溃疡临床特征的关系。
在伴有严重发绀的情况下，常规治疗无效的非指端溃疡经波生坦治疗后明显改善。相比之下，无发绀的非指端溃疡仍对波生坦治疗无反应。
波生坦可能对加速严重发绀的非指端溃疡愈合有效，提示严重外周循环受损引起的非指端溃疡对此治疗反应良好。
