Conditions: Scleroderma, Systemic Scleroderma, Diffuse Scleroderma, Limited Raynaud Phenomenon
Keywords: Sildenafil Endothelial Progenitor Cells Laser Doppler Imaging
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 41
Healthy volunteers: no

Brief summary:
Early phases of systemic sclerosis is characterized by inflammatory and microvasculature alterations. Sildenafil citrate has been shown to have vasodilatory effects and to enhance vasculogenesis. The purpose of this study is to evaluate the effect of sildenafil citrate on hand blood flow of patients with systemic sclerosis, using Laser Doppler Imaging.

Detailed description:
Progressive microangiopathy and endothelial dysfunction are identified in early phases of systemic sclerosis. These alterations may result in progressive reduction of vessel lumen, decreased blood flow, and a state of chronic hypoxia resulting in digital ulcers, digital pitting, and, in more severe cases, gangrene and amputation of the extremities. Few studies aimed to evaluate the effects of Sildenafil on the microcirculatory blood flow in patients with Raynaud's phenomenon secondary to systemic sclerosis (SS). Moreover, no study has evaluated the effect of this drug on the number and function of endothelial progenitor cells in SS patients. The relatively new technique of laser Doppler imaging (LDI) allows an objective measurement of superficial cutaneous microvascular blood flow and constitutes a promising approach in the assessment of the digital microvascular vasoreactivity in response to cold stimulus or in response to treatment in SSc patients.

Arms:
arm 1: Oral Sildenafil citrate, 50mg, b.i.d. arm 2: Placebo pill (identical to Sildenafil citrate 50mg), b.i.d.

Interventions: intervention 1: Sildenafil citrate intervention 2: Placebo (Sugar pill)
Intervention descriptions: intervention 1: Oral sildenafil citratre, 50mg b.i.d., 8 weeks intervention 2: Placebo pills similar to sildenafil citrate pills, b.i.d for 8 weeks

Protocol document: