Ruaro Barbara, Pizzorni Carmen, Paolino Sabrina, Alessandri Elisa, Sulli Alberto
Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy.
Front Pharmacol. 2019 Apr 4;10:293. doi: 10.3389/fphar.2019.00293. eCollection 2019.
The aim of this six-month open feasibility study was to evaluate skin blood perfusion and clinical symptom changes during aminaphtone treatment in patients with either primary or secondary Raynaud's phenomenon to systemic sclerosis.
Ninety-two patients referring for Raynaud's phenomenon have been enrolled in November during routine clinical assessment, after informed consent. Aminaphtone was administered 75 mg twice daily in addition to current treatments to forty-six patients. Skin blood perfusion was measured by Laser Speckle Contrast Analysis (LASCA) at the level of fingertips, periungual areas, dorsum and palm of hands, and face at baseline (W0), after one (W1), four (W4), twelve (W12) and twenty-four (W24) weeks of treatment. Raynaud's condition score (RCS) and both frequency and duration of Raynaud's attacks were assessed at the same time.
Compared with the control group, despite colder period of the year, aminaphtone treated patients showed a progressive statistically significant increase of blood perfusion, as well as a decrease of RCS, frequency of Raynaud's attacks/day and their duration, from W0 to W12 in all skin areas. From W12 to W24 no further increase of blood perfusion was observed. The results were similar in both primary and secondary Raynaud's phenomenon patients. Five weeks after aminaphtone discontinuation blood perfusion values were significantly higher than those at baseline in the majority of skin areas.
This study demonstrates that aminaphtone treatment increases skin blood perfusion and improves Raynaud's phenomenon clinical symptoms, with sustained efficacy up to 6 months, even in patients with systemic sclerosis. A randomized, blind, controlled, clinical trial including a larger number of subjects is advisable to confirm these early results.
这项为期6个月的开放性可行性研究旨在评估氨萘非特治疗原发性或继发性雷诺现象合并系统性硬化症患者期间的皮肤血流灌注及临床症状变化。
92例因雷诺现象前来就诊的患者于11月在常规临床评估期间签署知情同意书后入组。46例患者在当前治疗基础上,加用氨萘非特,每日2次,每次75mg。在治疗基线期(W0)、治疗1周(W1)、4周(W4)、12周(W12)和24周(W24)时,采用激光散斑对比分析(LASCA)测量指尖、甲周区域、手背、手掌及面部的皮肤血流灌注。同时评估雷诺病情评分(RCS)以及雷诺发作的频率和持续时间。
与对照组相比,尽管处于一年中较寒冷的时期,但氨萘非特治疗组患者在所有皮肤区域从W0至W12均显示出血流灌注有统计学意义的逐步显著增加,同时RCS、每日雷诺发作频率及其持续时间均有所降低。从W12至W24未观察到血流灌注进一步增加。原发性和继发性雷诺现象患者的结果相似。停用氨萘非特5周后,大多数皮肤区域的血流灌注值显著高于基线水平。
本研究表明,氨萘非特治疗可增加皮肤血流灌注并改善雷诺现象的临床症状,即使对于系统性硬化症患者,其疗效可持续6个月。建议开展一项纳入更多受试者的随机、盲法、对照临床试验以证实这些早期结果。