Differing commissioning arrangements may contribute to geographic variation in clinical management of digital ulcers in systemic sclerosis.
Systemic sclerosis
digital ulcer
endothelin receptor antagonist
phosphodiesterase inhibitors
scleroderma
Journal
Clinical medicine (London, England)
ISSN: 1473-4893
Titre abrégé: Clin Med (Lond)
Pays: England
ID NLM: 101092853
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
entrez:
17
5
2020
pubmed:
18
5
2020
medline:
15
5
2021
Statut:
ppublish
Résumé
Phosphodiesterase inhibitors (such as sildenafil) and endothelin receptor antagonist, bosentan, are effective for digital ulcer disease in systemic sclerosis (SSc-DU) and are endorsed in international treatment recommendations. Commissioning of high-cost drugs, such as bosentan, however, differs across devolved nations of the UK. We report a multicentre service evaluation project to examine 'real world' management of SSc-DU before and following the 2015 UK Scleroderma Study Group (UKSSG) guidance, across south-west (SW) England and Wales. Results showed that iloprost and sildenafil use for SSc-DU was higher in patients in Wales prior to 2015. Between 2015-2017, sildenafil use for SSc-DU increased in SW England while remaining stable in Wales. Bosentan use for SSc-DU after 2015 in SW England increased, while remaining stable and proportionately lower in Wales. These findings demonstrate that differing commissioning guidance across devolved nations of the UK seems to contribute to geographic variation in patient care.
Identifiants
pubmed: 32414728
pii: 20/3/343
doi: 10.7861/clinmed.2020-0031
pmc: PMC7354016
doi:
Substances chimiques
Sulfonamides
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
343-345Informations de copyright
© Royal College of Physicians 2020. All rights reserved.
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