Maltez Nancy, Ross Laura, Baron Murray, Alunno Alessia, Campochiaro Corrado, Suliman Yossra A, Schoones Jan W, Allanore Yannick, Del Galdo Francesco, Denton Christopher P, Distler Oliver, Frech Tracy, Furst Daniel E, Giuggioli Dilia, Khanna Dinesh, Krieg Thomas, Kuwana Masataka, Matucci-Cerinic Marco, Moinzadeh Pia, Pope Janet, Chung Lorinda, Hughes Michael
Division of Rheumatology, Department of Medicine, Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
Department of Medicine and Rheumatology, University of Melbourne at St Vincent's Hospital, Melbourne, VIC, Australia.
J Scleroderma Relat Disord. 2025 Aug 19:23971983251340559. doi: 10.1177/23971983251340559.
Digital ulcers are an important disease manifestation of systemic sclerosis and are associated with significant morbidity. As such, there is an urgent need for the development of evidence-based recommendations to guide clinicians in the treatment of digital ulcers.
A steering committee of international experts was established. A systematic review of the literature pertaining to the use of pharmacologic treatments in the management of digital ulcers was performed to inform the development of treatment recommendations for systemic sclerosis digital ulcers. Consensus methodology was used to develop the final treatment recommendations.
The World Scleroderma Foundation committee agreed on 8 overarching treatment principles and 10 pharmacologic treatment recommendations for the management of systemic sclerosis digital ulcers. Phosphodiesterase 5 inhibitors and intravenous iloprost were recommended for the management of acute digital ulcers. Bosentan was recommended for prevention of digital ulcers.
This study has yielded pragmatic treatment recommendations to direct treatment decisions for the management of systemic sclerosis digital ulcers. In addition, results have highlighted areas in need of future research in order to improve patient outcomes.
指端溃疡是系统性硬化症的一种重要疾病表现，且与显著的发病率相关。因此，迫切需要制定基于证据的建议，以指导临床医生治疗指端溃疡。
成立了一个国际专家指导委员会。对有关药物治疗在指端溃疡管理中的应用的文献进行了系统综述，以为系统性硬化症指端溃疡的治疗建议制定提供参考。采用共识方法制定最终的治疗建议。
世界硬皮病基金会委员会就系统性硬化症指端溃疡的管理达成了8项总体治疗原则和10项药物治疗建议。磷酸二酯酶5抑制剂和静脉注射伊洛前列素被推荐用于急性指端溃疡的管理。波生坦被推荐用于预防指端溃疡。
本研究产生了实用的治疗建议，以指导系统性硬化症指端溃疡管理的治疗决策。此外，研究结果突出了为改善患者预后而需要在未来进行研究的领域。
