Scleroderma Vasodilation: New Drug Combinations
- new research indicates that vasoactive vasodilating drugs (VVDs) could play a protective role against the development of interstitial lung disease (ILD) in patients with systemic sclerosis (ssc).The findings,...
- One study focused on how exposure too prostanoids and endothelin receptor antagonists (ERAs) impacts ILD progression.
- Another study, encompassing data from 4,091 patients, explored the association between VVDs, immunosuppressants, and the onset of SSc-ILD.
Vasoactive vasodilating drugs (VVDs) show promise in protecting against interstitial lung disease (ILD) in systemic sclerosis (SSc), according to fresh research. Discover how specific drug combinations, including prostanoids and endothelin receptor antagonists (ERAs), may reduce the risk of ILD progression. This vital news from the EUSTAR database highlights the potential of sildenafil and iloprost, showing a protective effect within one year. Learn how these findings, published on June 14, 2025, could reshape treatment strategies for this rare, autoimmune condition. News Directory 3 is committed to delivering the latest medical breakthroughs. understand the role of digital ulcers, and how they may influence the effects of vasodilation therapies. Discover what’s next for SSc treatment and potential drug combinations.
Vasodilation Therapies Show Promise for Systemic Sclerosis
new research indicates that vasoactive vasodilating drugs (VVDs) could play a protective role against the development of interstitial lung disease (ILD) in patients with systemic sclerosis (ssc).The findings, drawn from multiple analyses of the EUSTAR database, suggest that specific VVDs, particularly when combined with other treatments, may offer important benefits.
One study focused on how exposure too prostanoids and endothelin receptor antagonists (ERAs) impacts ILD progression. The results indicated that prostanoid exposure is linked to a reduced risk of ILD progression in patients exhibiting mild vasculopathy, characterized by the absence of digital ulcers but higher diffusion capacity for carbon monoxide (DLCO). Conversely, ERA exposure appeared to correlate with a lower risk of worsening symptoms, especially in patients with more severe vasculopathy and lower DLCO.
Another study, encompassing data from 4,091 patients, explored the association between VVDs, immunosuppressants, and the onset of SSc-ILD. This analysis considered ERAs, phosphodiesterase type 5 inhibitors (PDE5i), prostanoids, and both conventional and biologic immunosuppressants.The findings revealed that PDE5i and prostanoids where significantly associated with ILD onset.
While the association was observed for the prostanoid class, a statistically significant interaction for PDE5i emerged only in combination with digital ulcers, where exposure to PDE5i was associated with a reduced risk of ILD onset. Although there was a significant association between the interaction of conventional immunosuppressants and diffuse cutaneous SSc with the risk of ILD onset, this translated into only a trend toward protection from ILD onset.
Cosimo Bruni said, “We showed that treatment with major VVD, specifically sildenafil and iloprost—but not immunosuppressants—might have a protective effect on the development of SSc-ILD within 1 year.”
A sensitivity analysis, dividing the observation period before and after the 2015 EULAR SSc treatment recommendations, revealed an increase in patients with digital ulcers, rising from 18.5% to 42.1%. this increase was attributed to heightened awareness and improved identification.
The analysis also confirmed the protective associations of prostanoids, iloprost, and the interaction between sildenafil and digital ulcers in the period before 2015. Post-2015 data reinforced the protective interaction of PDE5i, sildenafil, and digital ulcers for ILD onset, but not for prostanoids or iloprost.
What’s next
These studies suggest that the effectiveness of VVDs may depend on the presence of digital ulcers, highlighting the need for tailored interventions based on individual clinical scenarios. Further randomized controlled trials are necessary to investigate the preventive effects of these medications.