Treatment of Digital Ulcers in Korean Patients With Systemic Sclerosis: a Prospective Cohort Study
- Conditions
- Systemic SclerosisDigital UlcerRaynaud Disease
- Registration Number
- NCT02642146
- Lead Sponsor
- Seoul National University Hospital
- Brief Summary
This study evaluates the efficacy and safety of routine medical treatments of digital ulcers in patients with systemic sclerosis in a prospective cohort study.
- Detailed Description
Systemic sclerosis (SSc) is a chronic autoimmune disease of unknown etiology with high morbidity and mortality. SSc manifests by fibrosis of skin and internal organs. Although the underlying mechanisms are still subject to investigation, endothelial dysfunction and abnormal immune response are thought to contribute to vascular dysfunction and fibrosis in SSc.
A hallmark feature of SSc is the presence of Raynaud phenomenon (RP) that is caused by reversible vasoconstriction of digital arteries triggered by exposure to cold or emotional stress. In up to 33-43% of SSc patients, the ischemia can progress to digital ulcers (DUs), which are often associated not only with pain but also with severe limitation in the daily activity, anxiety and depression among others. In severe cases, RP can be complicated by superinfection or gangrene, requiring surgical amputation.
The mainstay treatment of RP is restoration of the decreased blood flow using calcium channel blocker, protstanoids, phosphodiesterse V inhibitor, and endothelin receptor blocker. However, the efficacy and safety of those medications in RP-associated ulcers have not been definitive, especially in Korean patients with SSc. In addition, it remains unknown whether Korean SSc patients respond better to a treatment over others.
Study aims include
1. To establish a new prospective cohort of SSc patients with DU in Korea..
2. To investigate the current situation of SSc patients in Korea.
3. To investigate and compare the efficacy and safety of current medical treatments of DU in SSc patients in Korea
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 71
- Age of 18 years or older
- SSc diagnosis according to 1980 or 2013 ACR classification criteria
- 1 or more active DU
- Patients who start or change medical treatment for DU
- Patients who are willing to participate
- Pregnancy or active breast feeding
- Patients with life expectancy < 6 months
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Time to resolution of cardinal DU weeks or days (from baseline)
- Secondary Outcome Measures
Name Time Method Number of new DU weeks 4, 8, 12, 24 Number of patients with superinfection weeks 4, 8, 12, 24 Change in size of cardinal DU from baseline weeks 4, 8, 12, 24 weeks Change in DU number from baseline weeks 4, 8, 12, 24 Case of successful digital ulcer treatment with tolerable side weeks 4, 8, 12, 24
Trial Locations
- Locations (1)
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of