Vasoactive Therapy in Systemic Sclerosis: Real-life Therapeutic Practice in More Than 3000 Patients

Moinzadeh P, Riemekasten G, Siegert E, Fierlbeck G, Henes J, Blank N, Melchers I, Mueller-Ladner U, Frerix M, Kreuter A, Tigges C, Lahner N, Susok L, Günther C, Zeidler G, Pfeiffer C, Worm M, Karrer S, Aberer E, Bretterklieber A, Genth E, Simon JC, Distler J, Hein R, Schneider M, Seitz CS, Herink C, Steinbrink K, Sardy M, Varga R, Mensing H, Mensing C, Lehmann P, Neeck G, Fiehn C, Weber M, Goebeler M, Burkhardt H, Buslau M, Ahmadi-Simab K, Himsel A, Juche A, Koetter I, Kuhn A, Sticherling M, Hellmich M, Kuhr K, Krieg T, Ehrchen J, Sunderkoetter C, Hunzelmann N (2016)

Publication Type: Journal article

Publication year: 2016

Journal

Book Volume: 43

Pages Range: 66-74

Journal Issue: 1

DOI: 10.3899/jrheum.150382

Abstract

Vasculopathy is a key factor in the pathophysiology of systemic sclerosis (SSc) and the main cause for Raynaud phenomenon (RP), digital ulcers (DU), and/or pulmonary arterial hypertension (PAH). It is so far unknown how patients with SSc are treated with vasoactive agents in daily practice. To determine to which extent patients with SSc were treated with different vasoactive agents, we used data from the German Network for Systemic Scleroderma registry.The data of 3248 patients with SSc were analyzed.Patients were treated with vasoactive drugs in 61.1% of cases (1984/3248). Of these, 47.6% received calcium channel inhibitors, followed by 34.2% treated with angiotensin-converting enzyme (ACE) inhibitors, 21.1% treated with intravenous (IV) prostanoids, 10.1% with pentoxifylline, 8.8% with angiotensin 1 receptor antagonists (AT1RA), 8.7% with endothelin 1 receptor antagonists (ET1RA), 4.1% with phosphodiesterase type 5 (PDE5) inhibitors, and 5.3% with others. Patients with RP received vasoactive therapy in 63.3% of cases, with DU in 70.1%, and with PAH in 78.2% of cases. Logistic regression analysis revealed that patients with PAH were significantly more often treated with PDE5 inhibitors and ET1RA, and those with DU with ET1RA and IV prostanoids. In addition, 41.8% of patients were treated with ACE inhibitors and/or AT1RA. Patients registered after 2009 received significantly more often ET1RA, AT1RA, and IV prostanoids compared with patients registered prior to 2005.These data clearly indicate that many patients with SSc do not yet receive sufficient vasoactive therapy. Further, in recent years, a marked change of treatment regimens can be observed.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Köln Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) HELIOS Kliniken Germany (DE) Justus-Liebig-Universität Gießen Germany (DE) Universitätsklinikum Heidelberg Germany (DE) Universitätsklinikum Tübingen Germany (DE) Humboldt-Universität zu Berlin Germany (DE) Technische Universität München (TUM) Germany (DE) Universitätsklinikum Münster Germany (DE) Dermatologisches Ambulatorium Hamburg-Alstertal Germany (DE) Universitätsklinikum Düsseldorf Germany (DE) Universitätsklinikum Göttingen Germany (DE) Universitätsklinikum Leipzig Germany (DE) Universität zu Köln Germany (DE) Deutsches Krebsforschungszentrum (DKFZ) Germany (DE) Asklepios Kliniken Germany (DE) Immanuel Krankenhaus Berlin Germany (DE) GPR Gesundheits- und Pflegezentrum Rüsselsheim gemeinnützige GmbH Germany (DE) Klinikum Stephansplatz GmbH Germany (DE) Parkresort Rheinfelden Holding AG Switzerland (CH) Universitätsklinikum Frankfurt am Main (KGU) Germany (DE) Universitätsklinikum Würzburg Germany (DE) Krankenhaus Köln-Merheim - Klinikum der Universität Witten/Herdecke Germany (DE) ACURA Kliniken Germany (DE) Rheumazentrum Prof. Dr. med. Gunther Neeck Germany (DE) Ludwig-Maximilians-Universität (LMU) Germany (DE) Johannes Gutenberg-Universität Mainz (JGU) Germany (DE) Universitätsklinikum Regensburg Germany (DE) Universitätsklinikum Ulm Germany (DE) Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Ruhr-Universität Bochum (RUB) Germany (DE)

How to cite

APA:

Moinzadeh, P., Riemekasten, G., Siegert, E., Fierlbeck, G., Henes, J., Blank, N.,... Hunzelmann, N. (2016). Vasoactive Therapy in Systemic Sclerosis: Real-life Therapeutic Practice in More Than 3000 Patients. Journal of Rheumatology, 43(1), 66-74. https://doi.org/10.3899/jrheum.150382

MLA:

Moinzadeh, Pia, et al. "Vasoactive Therapy in Systemic Sclerosis: Real-life Therapeutic Practice in More Than 3000 Patients." Journal of Rheumatology 43.1 (2016): 66-74.

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