The treatment with N-acetylcysteine of Raynaud's phenomenon and ischemic ulcers therapy in sclerodermic patients: a prospective observational study of 50 patients

Clin Rheumatol. 2009 Dec;28(12):1379-84. doi: 10.1007/s10067-009-1251-7. Epub 2009 Aug 20.

Abstract

N-Acetylcysteine is useful in the short-term treatment of severe Raynaud's phenomenon and digital ulcers (DU) in patients with systemic sclerosis (SSc), but its long-term effects are largely unknown. The aim of this study was to report long-term outcome (median follow-up 3 years) in a prospective study of a cohort of 50 consecutive patients with SSc who received N-acetylcysteine (NAC) infusional therapy every 2 weeks. We observed a reduction of DU/patient/year (4.5 +/- 3.1 vs 0.81 +/- 0.79) and DU ulcer visual analog scale (VAS; 6.88 +/- 2.62 vs 3.20 +/- 1.80), a decrease of the Raynaud's phenomenon (RP) number attacks (7.18 +/- 3.87 vs 3 +/- 1.92), and RP VAS (6.24 +/- 1.92 vs 3.62 +/- 1.48). In this study, we did not observe serious adverse events in patients. Minor side effects were flushing (two patients) and headache (one patient). NAC infusion was generally well tolerated, and nobody had to discontinue the treatment. In conclusion, long-term therapy with NAC, in patients with SSc, has a durable effectiveness on ischemic ulcers and Raynaud's phenomenon.

MeSH terms

  • Acetylcysteine / administration & dosage
  • Acetylcysteine / therapeutic use*
  • Female
  • Fingers
  • Free Radical Scavengers / administration & dosage
  • Free Radical Scavengers / therapeutic use*
  • Humans
  • Infusions, Intravenous
  • Ischemia / complications
  • Ischemia / drug therapy*
  • Ischemia / pathology
  • Male
  • Middle Aged
  • Raynaud Disease / complications
  • Raynaud Disease / drug therapy*
  • Raynaud Disease / pathology
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / drug therapy*
  • Scleroderma, Systemic / pathology
  • Skin / blood supply
  • Skin Ulcer / complications
  • Skin Ulcer / drug therapy*
  • Skin Ulcer / pathology
  • Treatment Outcome

Substances

  • Free Radical Scavengers
  • Acetylcysteine