Iloprost is used to treat high blood pressure in the lungs, known also pulmonary arterial hypertension (PAH). The therapy is a form of prostacyclin and is similar to a substance in the body that dilates blood vessels, including those in the lungs, so as to help decrease blood pressure in the lungs.1

Iloprost has also been used for treating Raynaud’s phenomenon when oral or topical vasodilators are ineffective.2

The most common side effects experienced by patients taking iloprost are back pain, dizziness, flushing, headache, increased cough, jaw tightness, light-headedness, muscle cramps, nausea, tongue pain, sleeping disorders, vomiting, and weakness.1

Clinical trials of iloprost

A recently published study regarding iloprost’s use in people with scleroderma³ found patients experienced significant improvements in several areas, including the measure of sclerosis on the skin, pulmonary arterial pressure, and pro-brain natriuretic peptide.³ These results suggest that continued treatment with intravenous iloprost may improve cardiopulmonary function and blood vessel anomalies in people with scleroderma.

“The administration of an intensive IV iloprost regimen, in combination with bosentan when indicated, improved pre-existing ulcer healing and prevented the occurrence of new DUs [digital ulcers], confirming the importance of these two therapeutic options in the management of SSc vasculopathy,” the researchers wrote in the study, published in October 2016 in the journal Rheumatology International.

“Thus, since the administration of a single 5-day IV iloprost infusion cycle was already known to improve RP [Raynaud’s phenomenon] and heal DUs, the present results indicate that its monthly repetition maintains a favourable healing effect, and reduce the occurrence of new DUs over time,” they concluded.

A study comparing two treatments for digital ulcers in systemic sclerosis is currently recruiting participants (NCT01836263). This is an observational study, part of a European Union project  to determine the best ways of managing systemic sclerosis so as to improve treatment strategies and, subsequently, the quality of everyday life for people with scleroderma.

This study has two arms, one focused on healing and the other on prevention. Patients in both arms will receive either a combination of calcium channel blockers (CCB) and intravenous iloprost, or a combination of bosentan, an endothelin receptor antagonist, and sildenafil, a Phosphodiesterase-5 inhibitor. Those with active digital ulcers will be part of the healing arm, while patients without a history of digital ulcers, and certainly no active ulcers, will be in the prevention arm.

The study’s estimated completion date is June 2017.

 

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  1. https://www.drugs.com/cdi/iloprost.html
  2. http://www.uptodate.com/contents/treatment-of-the-raynaud-phenomenon-resistant-to-initial-therapy
  3. http://link.springer.com/article/10.1007%2Fs00296-016-3582-4#Sec