Cargando…

Improvement of peripheral artery disease with Sildenafil and Bosentan combined therapy in a patient with limited cutaneous systemic sclerosis: A case report

RATIONALE: Sildenafil, a phosphodiesterase-5-inhibitor and Bosentan, an endothelin-1-receptor antagonist combined therapy could have beneficial effect in systemic sclerosis (SSc) patients with peripheral artery disease. PATIENT CONCERNS: We report a case of a 48-year-old Black woman, who developed s...

Descripción completa

Detalles Bibliográficos
Autores principales: Omarjee, Loukman, Fontaine, Cedric, Mahe, Guillaume, Jaquinandi, Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484185/
https://www.ncbi.nlm.nih.gov/pubmed/28640077
http://dx.doi.org/10.1097/MD.0000000000006988
_version_ 1783245831688683520
author Omarjee, Loukman
Fontaine, Cedric
Mahe, Guillaume
Jaquinandi, Vincent
author_facet Omarjee, Loukman
Fontaine, Cedric
Mahe, Guillaume
Jaquinandi, Vincent
author_sort Omarjee, Loukman
collection PubMed
description RATIONALE: Sildenafil, a phosphodiesterase-5-inhibitor and Bosentan, an endothelin-1-receptor antagonist combined therapy could have beneficial effect in systemic sclerosis (SSc) patients with peripheral artery disease. PATIENT CONCERNS: We report a case of a 48-year-old Black woman, who developed severe left limb claudication and walking limitation following a left femoropopliteal bypass occlusion in 2014. She was a heavy smoker and had a history of right middle cerebral artery ischemic stroke and bilateral Raynaud phenomenon. DIAGNOSES: According to the American College of Rheumatology/European League Against Rheumatism-2013 criteria, diagnosis of limited cutaneous SSc was retained with macrovascular lesions. She was referred for investigation of left limb claudication on treadmill using transcutaneous oxygen pressure measurement during exercise to argue for the vascular origin of the walking impairment. She had a severe left limb ischemia and the maximum walking distance (MWD) she reached was 118 m in March 2015 despite the medical optimal treatment and walking rehabilitation. INTERVENTIONS: Sildenafil, 20 mg tid, was introduced due to active digital ulcers. In July 2015, the MWD increased to 288 m, then to 452 m in December 2015. Adding Bosentan to Sildenafil to prevent recurrent digital ulcers resulted in an MWD of 1576 m. OUTCOMES: Recently, the patient is treated with the combined therapy. She has no more pain during walking and his quality of life has improved. LESSONS: Sildenafil and Bosentan combined therapy was associated in our case with an improvement of MWD without adverse effect. Further clinical trials are necessary to confirm our original observation.
format Online
Article
Text
id pubmed-5484185
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-54841852017-07-06 Improvement of peripheral artery disease with Sildenafil and Bosentan combined therapy in a patient with limited cutaneous systemic sclerosis: A case report Omarjee, Loukman Fontaine, Cedric Mahe, Guillaume Jaquinandi, Vincent Medicine (Baltimore) 6900 RATIONALE: Sildenafil, a phosphodiesterase-5-inhibitor and Bosentan, an endothelin-1-receptor antagonist combined therapy could have beneficial effect in systemic sclerosis (SSc) patients with peripheral artery disease. PATIENT CONCERNS: We report a case of a 48-year-old Black woman, who developed severe left limb claudication and walking limitation following a left femoropopliteal bypass occlusion in 2014. She was a heavy smoker and had a history of right middle cerebral artery ischemic stroke and bilateral Raynaud phenomenon. DIAGNOSES: According to the American College of Rheumatology/European League Against Rheumatism-2013 criteria, diagnosis of limited cutaneous SSc was retained with macrovascular lesions. She was referred for investigation of left limb claudication on treadmill using transcutaneous oxygen pressure measurement during exercise to argue for the vascular origin of the walking impairment. She had a severe left limb ischemia and the maximum walking distance (MWD) she reached was 118 m in March 2015 despite the medical optimal treatment and walking rehabilitation. INTERVENTIONS: Sildenafil, 20 mg tid, was introduced due to active digital ulcers. In July 2015, the MWD increased to 288 m, then to 452 m in December 2015. Adding Bosentan to Sildenafil to prevent recurrent digital ulcers resulted in an MWD of 1576 m. OUTCOMES: Recently, the patient is treated with the combined therapy. She has no more pain during walking and his quality of life has improved. LESSONS: Sildenafil and Bosentan combined therapy was associated in our case with an improvement of MWD without adverse effect. Further clinical trials are necessary to confirm our original observation. Wolters Kluwer Health 2017-06-23 /pmc/articles/PMC5484185/ /pubmed/28640077 http://dx.doi.org/10.1097/MD.0000000000006988 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 6900
Omarjee, Loukman
Fontaine, Cedric
Mahe, Guillaume
Jaquinandi, Vincent
Improvement of peripheral artery disease with Sildenafil and Bosentan combined therapy in a patient with limited cutaneous systemic sclerosis: A case report
title Improvement of peripheral artery disease with Sildenafil and Bosentan combined therapy in a patient with limited cutaneous systemic sclerosis: A case report
title_full Improvement of peripheral artery disease with Sildenafil and Bosentan combined therapy in a patient with limited cutaneous systemic sclerosis: A case report
title_fullStr Improvement of peripheral artery disease with Sildenafil and Bosentan combined therapy in a patient with limited cutaneous systemic sclerosis: A case report
title_full_unstemmed Improvement of peripheral artery disease with Sildenafil and Bosentan combined therapy in a patient with limited cutaneous systemic sclerosis: A case report
title_short Improvement of peripheral artery disease with Sildenafil and Bosentan combined therapy in a patient with limited cutaneous systemic sclerosis: A case report
title_sort improvement of peripheral artery disease with sildenafil and bosentan combined therapy in a patient with limited cutaneous systemic sclerosis: a case report
topic 6900
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484185/
https://www.ncbi.nlm.nih.gov/pubmed/28640077
http://dx.doi.org/10.1097/MD.0000000000006988
work_keys_str_mv AT omarjeeloukman improvementofperipheralarterydiseasewithsildenafilandbosentancombinedtherapyinapatientwithlimitedcutaneoussystemicsclerosisacasereport
AT fontainecedric improvementofperipheralarterydiseasewithsildenafilandbosentancombinedtherapyinapatientwithlimitedcutaneoussystemicsclerosisacasereport
AT maheguillaume improvementofperipheralarterydiseasewithsildenafilandbosentancombinedtherapyinapatientwithlimitedcutaneoussystemicsclerosisacasereport
AT jaquinandivincent improvementofperipheralarterydiseasewithsildenafilandbosentancombinedtherapyinapatientwithlimitedcutaneoussystemicsclerosisacasereport