Iloprost Found To Mitigate Raynaud’s Syndrome Symptoms and Heal Associated Digital Ulcers

Patrícia Silva, PhD avatar

by Patrícia Silva, PhD |

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According to a news release, it was recently revealed at the European League Against Rheumatism (EULAR) Annual European Congress of Rheumatology, on June 2015 that the drug iloprost can mitigate Raynaud’s syndrome and prevent the development of digital ulcers.

Raynaud’s syndrome is a disorder characterized by excessively reduced blood flow in digital arteries causing discoloration of the fingers and toes. The syndrome manifests in response to cold temperatures or emotional stress, and is thought to be caused by vasospasms that decrease blood supply. Raynaud’s syndrome may be primary or secondary to an underlying condition.

In secondary Raynaud’s, the syndrome is caused by a known primary disease, usually connective tissue disorders including scleroderma, a rare, chronic autoimmune disease in which the body’s own immune system attacks healthy tissues resulting in a hardening and tightening of the skin and connective tissues due to excessive collagen deposition. The disease usually affects the skin, but it can also affect internal organs such as the lungs, heart, blood vessels, kidneys and the digestive tract. Patients with secondary Raynaud’s associated to scleroderma can develop ulcers in their fingertips due to the repeated spasm episodes.

Iloprost is a mediation with vasodilation properties that facilitates blood flow. At the meeting, researchers demonstrated that iloprost was more effective than alprostadil (also a vasodilator) as a therapy for secondary Raynaud’s syndrome. In addition, the team found that iloprost may be able to prevent the development of digital ulcers.

The team analyzed a cohort of 25 patients with secondary Raynaud’s syndrome who had received treatment with prostanoids. Of the patients, 20 had scleroderma, one patient had rheumatoid arthritis, another one systemic lupus erythematosus, one cryoglobulinemic vasculitis and the remaining two patients had overlapping diseases among the ones mentioned.

It was reported that 80% of the patients analyzed had finger pallor and numbness, 68% complained of digital pain, 44% had fingertip clefts, 40% had digital tip ulcerations and 16% fingertip pitting scars. The symptoms were found to be constant in 56% of the patients. Joint and muscular involvement was found in 76% of the patients, while 68% had lung involvement and 56% heart disease.

Six patients of the cohort received 25 µg intravenous iloprost for 3 to 5 days every 3 months, and ten patients received 20 µg intravenous alprostadil for 10 days every 6 months. A third group with the remaining nine patients received alprostadil or iloprost having switched therapies later on to iloprost or alprostadil, respectively.

Researchers found that overall both drugs were well tolerated by the patients. Iloprost treatment reduced the frequency of Raynaud’s syndrome symptoms onset by around 1.2 days and the duration of the attacks by 45 minutes in comparison to alprostadil. Regarding the Raynaud’s condition score, it was improved by 2.8 more points by iloprost treatment in comparison to alprostadil. The team found that patients under iloprost treatment for 24 months had healed digital clefts and ulcers. A significant reduction in the Health Assessment Questionnaire Disability Index was also observed in patients receiving iloprost.

The team concluded that Iloprost is a safe and effective therapy for secondary Raynaud’s syndrome as it can ease the disease’s symptoms, improve the disability grade and heal or prevent the development of digital ulcers.