[Reality of inpatient vasoactive treatment with prostacyclin derivatives in patients with acral circulation disorders due to systemic sclerosis in Germany].
Versorgungsrealität der stationären vasoaktiven Therapie mit Prostazyklinderivaten bei Patienten mit akralen Durchblutungsstörungen bei systemischer Sklerose in Deutschland.
Digital ulceration
Iloprost
Raynaud’s phenomenon
Scleroderma
Systemic sclerosis
Journal
Zeitschrift fur Rheumatologie
ISSN: 1435-1250
Titre abrégé: Z Rheumatol
Pays: Germany
ID NLM: 0414162
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
pubmed:
11
2
2020
medline:
15
12
2020
entrez:
11
2
2020
Statut:
ppublish
Résumé
Raynaud's phenomenon and the frequently ensuing digital ulcerations represent an early and very distressing symptom in patients with systemic sclerosis (scleroderma, SSc) causing significant limitations in the ability to work and quality of life. The use of vasoactive drugs (especially intravenous prostacyclin derivatives) is recommended to reduce the risk of hypoxic tissue damage up to the loss of fingers. In order to obtain information about the current state of treatment of patients with prostacyclin derivatives in routine clinical life in Germany, a survey was conducted among the centers affiliated to the German Network for Systemic Scleroderma (DNSS). In addition, a separate patient survey was conducted by the schleroderma self-help group (Sklerodermie Selbsthilfe e. V.), which only covered the symptoms Raynaud's syndrome, digital ulcers and the use of intravenous prostacyclin derivatives. Of the 433 patients surveyed 56% stated that they had already been treated with prostacyclin derivatives (iloprost/alprostadil) because of their illness and symptoms. A total of 61% received the treatment for severe Raynaud's phenomenon and 39% for digital ulcerations. Most respondents not only experienced an improvement in Raynaud's phenomenon and digital ulcers but also a significant improvement of limitations in everyday life. They also needed significantly less outside help and absenteeism from work was much lower. Patients consistently reported a positive effect of treatment with prostacyclin derivatives on Raynaud's phenomenon, acral ulcerations, pain and daily restrictions and felt well and safely cared for during inpatient treatment. These positive effects in the patients' perceptions provide crucial information supporting and confirming the current European and international treatment recommendations.
Sections du résumé
BACKGROUND
BACKGROUND
Raynaud's phenomenon and the frequently ensuing digital ulcerations represent an early and very distressing symptom in patients with systemic sclerosis (scleroderma, SSc) causing significant limitations in the ability to work and quality of life. The use of vasoactive drugs (especially intravenous prostacyclin derivatives) is recommended to reduce the risk of hypoxic tissue damage up to the loss of fingers.
METHODS
METHODS
In order to obtain information about the current state of treatment of patients with prostacyclin derivatives in routine clinical life in Germany, a survey was conducted among the centers affiliated to the German Network for Systemic Scleroderma (DNSS). In addition, a separate patient survey was conducted by the schleroderma self-help group (Sklerodermie Selbsthilfe e. V.), which only covered the symptoms Raynaud's syndrome, digital ulcers and the use of intravenous prostacyclin derivatives.
RESULTS
RESULTS
Of the 433 patients surveyed 56% stated that they had already been treated with prostacyclin derivatives (iloprost/alprostadil) because of their illness and symptoms. A total of 61% received the treatment for severe Raynaud's phenomenon and 39% for digital ulcerations. Most respondents not only experienced an improvement in Raynaud's phenomenon and digital ulcers but also a significant improvement of limitations in everyday life. They also needed significantly less outside help and absenteeism from work was much lower.
CONCLUSION
CONCLUSIONS
Patients consistently reported a positive effect of treatment with prostacyclin derivatives on Raynaud's phenomenon, acral ulcerations, pain and daily restrictions and felt well and safely cared for during inpatient treatment. These positive effects in the patients' perceptions provide crucial information supporting and confirming the current European and international treatment recommendations.
Identifiants
pubmed: 32040755
doi: 10.1007/s00393-019-00743-9
pii: 10.1007/s00393-019-00743-9
pmc: PMC7708340
doi:
Substances chimiques
Epoprostenol
DCR9Z582X0
Types de publication
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Pagination
1057-1066Références
Ann Rheum Dis. 1985 Nov;44(11):754-60
pubmed: 3904643
Cochrane Database Syst Rev. 2000;(2):CD000953
pubmed: 10796395
Rheumatology (Oxford). 2018 Aug 1;57(8):1408-1416
pubmed: 29733400
Minerva Cardioangiol. 1999 May;47(5):137-43
pubmed: 10479851
Arthritis Care Res (Hoboken). 2013 Sep;65(9):1460-71
pubmed: 23554239
Rheumatology (Oxford). 2008 Oct;47 Suppl 5:v46-7
pubmed: 18784143
Dtsch Med Wochenschr. 2012 Jan;137(1-2):34-40
pubmed: 22180282
J Dtsch Dermatol Ges. 2011 Jan;9(1):56-63
pubmed: 21083647
Clin Exp Med. 2019 Aug;19(3):357-366
pubmed: 30989453
J Rheumatol. 2016 Jan;43(1):66-74
pubmed: 26568599
Presse Med. 2006 Apr;35(4 Pt 1):587-92
pubmed: 16614599
Semin Arthritis Rheum. 2019 Feb;48(4):686-693
pubmed: 29706243
Br J Dermatol. 2016 Jun;174(6):1384-7
pubmed: 26708835
Ann Rheum Dis. 2016 Apr;75(4):681-6
pubmed: 25688073
Rheumatology (Oxford). 2010 Jul;49(7):1374-82
pubmed: 20400463
Lancet. 2017 Oct 7;390(10103):1685-1699
pubmed: 28413064
Ann Rheum Dis. 2017 Aug;76(8):1327-1339
pubmed: 27941129
Br J Dermatol. 2009 Apr;160(4):835-43
pubmed: 19183180
Ann Rheum Dis. 2011 Jan;70(1):32-8
pubmed: 20805294
Vasa. 2016;45(3):201-12
pubmed: 27129065
Ann Rheum Dis. 2016 Jun;75(6):1009-15
pubmed: 25995322