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Vascular Medicine
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Treprostinil for the treatment of severe digital necrosis in systemic sclerosis

Gregory Engel

Division of Cardiovascular Medicine, Stanford University School of Medicine, Falk Cardiovascular Research Center, Stanford, California, USA

Stanley G Rockson

Division of Cardiovascular Medicine, Stanford University School of Medicine, Falk Cardiovascular Research Center, Stanford, California, USA, srockson{at}cvmed.stanford.edu

We report a case of severe digital ulcerations associated with systemic sclerosis, successfully treated with treprostinil (Remodulin®). There was improvement within days of the treatment initiation; complete healing was accomplished after 16 weeks of therapy. Patients with systemic sclerosis and peripheral small vessel disease have limited therapeutic options. Treprostinil is a prostacyclin analogue that can be delivered by subcutaneous infusion and is approved in the USA only for treatment of primary pulmonary hypertension. This report provides an impressive example of an alternative, complementary indication for the use of treprostinil.

Key Words: digital ischemia • microvascular ischemia • prostacyclin • scleroderma • treprostinil

Vascular Medicine, Vol. 10, No. 1, 29-32 (2005)
DOI: 10.1191/1358863x05vm579cr
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