Practice pattern for the use of intravenous iloprost for the treatment of peripheral vasculopathy in systemic sclerosis: A case–control study from the Italian national multicenter “SPRING” (Systemic Sclerosis Progression InvestiGation) Registry-Reference-Cited by-同舟云学术

Practice pattern for the use of intravenous iloprost for the treatment of peripheral vasculopathy in systemic sclerosis: A case–control study from the Italian national multicenter “SPRING” (Systemic Sclerosis Progression InvestiGation) Registry

Published:2024-01-11 Issue: Volume: Page:
ISSN:2397-1983
Container-title:Journal of Scleroderma and Related Disorders
language:en
Short-container-title:Journal of Scleroderma and Related Disorders

Author:

Riccieri Valeria¹,Pellegrino Greta¹²^ORCID,Cipolletta Edoardo³,Giuggioli Dilia⁴^ORCID,Bajocchi Gianluigi⁵,Bellando-Randone Silvia⁶,Dagna Lorenzo⁷,Zanframundo Giovanni⁸^ORCID,Foti Rosario⁹,Cacciapaglia Fabio¹⁰,Cuomo Giovanna¹¹^ORCID,Ariani Alarico¹²,Rosato Edoardo¹³,Lepri Gemma⁶^ORCID,Girelli Francesco¹⁴,Zanatta Elisabetta¹⁵,Bosello Silvia Laura¹⁶,Cavazzana Ilaria¹⁷,Ingegnoli Francesca¹⁸,De Santis Maria¹⁹^ORCID,Murdaca Giuseppe²⁰^ORCID,Abignano Giuseppina²¹,Romeo Nicoletta²²,Della Rossa Alessandra²³,Caminiti Maurizio²⁴,Iuliano Annamaria²⁵,Ciano Giovanni²⁶,Beretta Lorenzo²⁷,Bagnato Gianluca²⁸,Lubrano Ennio²⁹^ORCID,De Andres Ilenia³⁰,Giollo Alessandro³¹,Saracco Marta³²,Agnes Cecilia³³,Lumetti Federica⁴,Spinella Amelia⁴,Magnani Luca⁵,Campochiaro Corrado⁷,De Luca Giacomo⁷^ORCID,Codullo Veronica⁸,Visalli Elisa⁹,Di Vico Claudio¹¹,Gigante Antonietta¹³,Saccon Francesca³⁴,Grazia Lazzaroni Maria¹⁷,Franceschini Franco¹⁷,Generali Elena¹⁹,Mennillo Gianna²¹,Barsotti Simone²³,Pagano Mariano Giuseppa²⁴,Calabrese Francesca²⁴,Furini Federica³⁵,Vultaggio Licia³⁵,Parisi Simone³⁶,Peroni Clara Lisa³⁶,Bianchi Gerolamo³⁷,Conti Fabrizio¹,Cozzi Franco³⁴,D’Angelo Salvatore²¹^ORCID,Doria Andrea¹⁵,Fusaro Enrico³⁶,Govoni Marcello³⁵,Guiducci Serena⁶,Iannone Florenzo¹⁰^ORCID,Salvarani Carlo⁴,Sebastiani Gian Domenico²⁵,Ferri Clodoveo⁴,Matucci-Cerinic Marco⁶,De Angelis Rossella³

Affiliation:

1. Department of Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy

2. Department of Rheumatology, IRCCS Ospedale Galeazzi–Sant’Ambrogio, Milan, Italy

3. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy

4. Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena, Italy

5. Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy

6. Department of Experimental and Clinical Medicine, Division of Rheumatology, AOUC, University of Florence, Florence, Italy

7. Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milano, Italy

8. Department of Rheumatology, Policlinico San Matteo, Pavia, Italy

9. Rheumatology Unit, A.O.U Policlinico S. Marco, Catania, Italy

10. Rheumatology Unit, Department of Precision and Regenerative Medicine-Ionian Area, University of Bari “Aldo Moro,” Bari, Italy

11. Department of Precision Medicine, University of Campania “Luigi Vanvitelli,” Naples, Italy

12. Department of Medicine, Internal Medicine and Rheumatology, Azienda Ospedaliero Universitaria di Parma, Parma, Italy

13. Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy

14. Department of Medicine, Rheumatology Unit, Ospedale GB Morgagni—L Pierantoni, Forlì, Italy

15. Rheumatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy

16. Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy

17. Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, ASST Spedali Civili of Brescia and University of Brescia, Brescia, Italy

18. Division of Clinical Rheumatology, ASST Pini, Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Research Center for Environmental Health, Università degli Studi di Milano, Milan, Italy

19. Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Italy

20. Department of Internal Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

21. Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital, Potenza, Italy

22. Rheumatology Unit, ASO Santa Croce e Carle, Cuneo, Italy

23. Department of Rheumatology, University of Pisa, Pisa, Italy

24. Departmental Rheumatology Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy

25. Rheumatology Unit, San Camillo Forlanini Hospital, Rome, Italy

26. Hospital of Ariano Irpino, Local Health Department, Ariano Irpino, Italy

27. Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy

28. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

29. Department of Rheumatology, University of Molise, Campobasso, Italy

30. Rheumatology Unit, Azienda Ospedaliera di Rilievo Nazionale ed Alta Specializzazione “Garibaldi,” Catania, Italy

31. Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy

32. Ospedale Mauriziano, Torino, Italy

33. San Lorenzo Hospital, Turin, Italy

34. Department of Medicine, Villa Salus Hospital, Venice, Italy

35. Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Ferrara, Italy

36. Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy

37. Rheumatology Unit, Department of Musculoskeletal Sciences, Local Health Trust 3, La Colletta Hospital, Genoa, Italy

Abstract

Background: Intravenous iloprost has been widely used for the treatment of systemic sclerosis peripheral vasculopathy. No agreement has been found on the regimen and the dosage of intravenous iloprost in different scleroderma subset conditions. This study aimed to evaluate the modalities of intravenous iloprost administration within a large cohort of systemic sclerosis patients from the SPRING Registry and to identify any associated clinical-demographic, instrumental or therapeutic data. Patients and Methods: Data of systemic sclerosis patients treated with intravenous iloprost for at least 1 year (case group) were retrospectively analyzed, including different timing and duration of intravenous iloprost session, and compared with those of untreated patients (control group). Results: Out of 1895 analyzed patients, 937 (49%) received intravenous iloprost treatment, while 958 (51%) were assigned to the control group. Among cases, about 70% were treated every 4 weeks, 24% with an interval of more than 4 weeks, and only 6% of less than 4 weeks. Most patients receiving the treatment every 4 weeks, or less, underwent infusion cycle for 1 day only, while if it was scheduled with an interval of more than 4 weeks, a total number of 5 consecutive days of infusions was the preferred regimen. The comparison between the two groups revealed that patients treated with intravenous iloprost had a higher frequency of DUs (p < 0.001), pitting scars (p < 0.001), diffuse cutaneous involvement (p < 0.001), interstitial lung disease (p < 0.002), as well as higher rates of anti-topoisomerase I, “ late” scleroderma pattern at nailfold videocapillaroscopy. These findings were confirmed by multivariate analysis. Conclusion: Our data provide a picture on the Italian use of intravenous iloprost among systemic sclerosis patients and showed that it was usually employed in patients with a more aggressive spectrum of the disease. The disparity of intravenous iloprost treatment strategies in the different centers suggests the need of a rational therapeutical approach based on the clinical characteristics of different patients’ subsets.

Publisher

SAGE Publications

Subject

Immunology,Rheumatology,Immunology and Allergy

Link

http://journals.sagepub.com/doi/pdf/10.1177/23971983231209809

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