Resolution of Severe Digital Ulceration during a Course of Bosentan Therapy
Authors: Michael J. Snyder, Mary R. Jacobs, Rafael G. Grau, David S. Wilkes, Kenneth S. Knox
Journal: Annals of Internal Medicine (2005)

Letters3 May 2005Resolution of Severe Digital Ulceration during a Course of Bosentan TherapyMichael J. Snyder, MD, Mary R. Jacobs, MD, Rafael G. Grau, MD, David S. Wilkes, MD, and Kenneth S. Knox, MDMichael J. Snyder, MDFrom Indiana University School of Medicine, Indianapolis, IN 46202., Mary R. Jacobs, MDFrom Indiana University School of Medicine, Indianapolis, IN 46202., Rafael G. Grau, MDFrom Indiana University School of Medicine, Indianapolis, IN 46202., David S. Wilkes, MDFrom Indiana University School of Medicine, Indianapolis, IN 46202., and Kenneth S. Knox, MDFrom Indiana University School of Medicine, Indianapolis, IN 46202.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-9-200505030-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Bosentan, the dual endothelin-receptor antagonist, has proven efficacy for treatment of secondary pulmonary arterial hypertension in patients with systemic sclerosis (1). Preliminary observations suggest a role for endothelin antagonist therapy in patients with systemic sclerosis who experience the Raynaud phenomenon and associated digital ulceration (2).Objective: To describe a patient with systemic sclerosis and pulmonary arterial hypertension who had complete resolution of previously refractory digital ulcerations 4 months after initiation of bosentan therapy.Case Report: A 50-year-old man with a 10-year history of progressive systemic sclerosis developed worsening dyspnea and debilitating digital ulcers. The patient had ...References1. Rubin LJ, Badesch DB, Barst RJ, Galie N, Black CM, Keogh A, et al. Bosentan therapy for pulmonary arterial hypertension. N Engl J Med. 2002;346:896-903. [PMID: 11907289] CrossrefMedlineGoogle Scholar2. Humbert M, Cabane J. Successful treatment of systemic sclerosis digital ulcers and pulmonary arterial hypertension with endothelin receptor antagonist bosentan. Rheumatology (Oxford). 2003;42:191-3. [PMID: 12509640] CrossrefMedlineGoogle Scholar3. Schachna L, Wigley FM. Targeting mediators of vascular injury in scleroderma. Curr Opin Rheumatol. 2002;14:686-93. [PMID: 12410092] CrossrefMedlineGoogle Scholar4. Hachulla E, Coghlan JG. A new era in the management of pulmonary arterial hypertension related to scleroderma: endothelin receptor antagonism. Ann Rheum Dis. 2004;63:1009-14. [PMID: 15308510] CrossrefMedlineGoogle Scholar5. Korn JH, Mayes M, Matucci Cerinic M, Rainisio M, Pope J, Hachulla E, et al. Digital ulcers in systemic sclerosis: prevention by treatment with bosentan, an oral endothelin receptor antagonist. Arthritis Rheum. 2004;50:3985-93. [PMID: 15593188] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Michael J. Snyder, MD; Mary R. Jacobs, MD; Rafael G. Grau, MD; David S. Wilkes, MD; Kenneth S. Knox, MDAffiliations: From Indiana University School of Medicine, Indianapolis, IN 46202.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDigital ulcers in scleroderma patients: A retrospective observational studySystemic Sclerosis: Bilateral Improvement of Raynaud's Phenomenon with Unilateral Digital SympathectomyRecent Advances in the Treatment of Systemic SclerosisRole of endogenous endothelin in endothelial dysfunction in murine model of systemic sclerosis: tight skin mice 1Úlceras digitales en la esclerosis sistémicaThe endothelin system as a therapeutic target in cardiovascular disease: great expectations or bleak house?Recent Advances on Pathogenesis and Therapies in Systemic SclerosisBosentan et Ulcères DigitauxPolyarteritis Nodosa Resistant to Conventional Treatment in a Pediatric PatientRaynaud's phenomenonPhénomène de RaynaudPrise en charge thérapeutique de la sclérodermie systémiqueEndothelin axis polymorphisms in patients with sclerodermaBosentan for severe pulmonary arterial hypertension related to systemic sclerosis with interstitial lung diseaseDrug eruption due to bosentan in a patient with systemic sclerosisLe bosentan dans le traitement des ulcères digitaux évolutifs au cours de la sclérodermie systémique (9 cas) 3 May 2005Volume 142, Issue 9Page: 802-803KeywordsCellsDyspneaOxygenPneumoniaProstacyclinPulmonary fibrosisPulmonary hypertensionSclerodermaUlcersVasoconstriction ePublished: 3 May 2005 Issue Published: 3 May 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...