回顾性分析波生坦或伊洛前列素治疗系统性硬皮病患者中心性面毛细血管扩张症的频率。

Retrospective analysis of the frequency of centrofacial telangiectasia in systemic sclerosis patients treated with bosentan or ilomedin.

机构信息

Department of Dermatology, Medical Faculty, University of Duesseldorf, Moorenstrasse 5, D-40225 Duesseldorf, Germany.

出版信息

Eur J Med Res. 2014 Jan 10;19(1):2. doi: 10.1186/2047-783X-19-2.

DOI:10.1186/2047-783X-19-2

PMID:24410934

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3902062/

Abstract

BACKGROUND

Bosentan is a dual endothelin receptor antagonist initially introduced for the treatment of pulmonary arterial hypertension and recently approved for the treatment of digital ulcers in patients with systemic sclerosis (SSc). Our clinical observations indicate that bosentan therapy may be associated with an increased frequency of centrofacial telangiectasia (TAE). Here, we sought to analyze the frequency of TAE in patients with SSc who were treated with either bosentan or the prostacyclin analog iloprost.

METHODS

We conducted a retrospective analysis in 27 patients with SSc undergoing therapy with either bosentan (n = 11) or iloprost (n = 16). Standardized photodocumentations of all patients (n = 27) were obtained at a time point ten months after therapy initiation and analyzed. A subgroup of patients (bosentan: n = 6; iloprost: n = 6) was additionally photodocumented prior to therapy initiation, enabling an intraindividual analysis over the course of therapy.

RESULTS

After ten months of therapy patients with SSc receiving bosentan showed a significantly (P = 0.0028) higher frequency of centrofacial TAE (41.6 ± 27.8) as compared to patients with SSc receiving iloprost (14.3 ± 13.1). Detailed subgroup analysis revealed that the frequency of TAE in the bosentan group (n = 6 patients) increased markedly and significantly (P = 0.027) by 44.4 after ten months of therapy (TAE at therapy initiation: 10.8 ± 5.1; TAE after ten months of therapy: 55.2 ± 29.8), whereas an only minor increase of 1.9 was observed in the iloprost group (n = 6 patients; TAE at therapy initiation: 18.3 ± 14.5; TAE after ten months of therapy: 20.2 ± 15.5), yet without reaching statistical significance (P = 0.420).

CONCLUSIONS

The use of bosentan may be associated with an increased frequency of TAE in patients with SSc. Patients should be informed about this potential adverse effect prior to therapy. Treatment options may include camouflage or laser therapy.

摘要

背景

波生坦是一种双重内皮素受体拮抗剂，最初被引入治疗肺动脉高压，最近被批准用于治疗系统性硬化症（SSc）患者的手指溃疡。我们的临床观察表明，波生坦治疗可能与中心性面颈部毛细血管扩张（TAE）的频率增加有关。在这里，我们试图分析接受波生坦或前列环素类似物伊洛前列素治疗的 SSc 患者 TAE 的频率。

方法

我们对 27 例接受波生坦（n=11）或伊洛前列素（n=16）治疗的 SSc 患者进行了回顾性分析。在治疗开始后 10 个月，对所有患者（n=27）的标准摄影记录进行了分析。亚组患者（波生坦：n=6；伊洛前列素：n=6）在治疗前也进行了摄影记录，能够在治疗过程中进行个体内分析。

结果

接受波生坦治疗的 SSc 患者在治疗 10 个月后，中心性 TAE 的频率明显（P=0.0028）高于接受伊洛前列素治疗的患者（41.6±27.8）。详细的亚组分析显示，波生坦组（n=6 例患者）的 TAE 频率明显增加（P=0.027），增加了 44.4%（治疗开始时的 TAE：10.8±5.1；治疗 10 个月后的 TAE：55.2±29.8），而伊洛前列素组（n=6 例患者）的增加幅度较小，仅为 1.9%（治疗开始时的 TAE：18.3±14.5；治疗 10 个月后的 TAE：20.2±15.5），但无统计学意义（P=0.420）。