Lidocaine for Systemic Sclerosis: A Double-blind Randomized Clinical Trial PDF Print E-mail
Thursday, 10 February 2011 12:29
Systemic sclerosis (scleroderma; SSc) is an orphan disease with the highest case-specific mortality of any connective-tissue disease. Excessive collagen deposit in affected tissues is a key for the disease's pathogenesis and comprises most of the clinical manifestations.

Lidocaine seems to be an alternative treatment for scleroderma considering that: a) the patient's having excessive collagen deposits in tissues affected by scleroderma; b) the patient's demonstrating increased activity of the enzyme prolyl hydroxylase, an essential enzyme for the biosynthesis of collagen; and c) lidocaine's reducing the activity of prolyl hydroxylase. The aim of this study was to evaluate the efficacy and safety of lidocaine in treating scleroderma.

Methods: A randomized double-blind clinical trial included 24 patients with scleroderma randomized to receive lidocaine or placebo intravenously in three cycles of ten days each, with a one-month interval between them.

Outcomes: cutaneous (modified Rodnan skin score), oesophageal (manometry) and microvascular improvement (nailfold capillaroscopy); improvement in subjective self-assessment and in quality of life (HAQ).

Results: There was no statistically significant difference between the groups for any outcome after the treatment and after 6-months follow-up. Improvement in modified Rodnan skin score occurred in 66.7% and 50% of placebo and lidocaine group, respectively (p=0.408). Both groups showed an improvement in subjective self-assessment, with no difference between them.

Conclusions: Despite the findings of a previous cohort study favouring the use of lidocaine, this study demonstrated that lidocaine at this dosage and means of administration showed a lack of efficacy for treating scleroderma's cutaneous, oesophageal and microvascular manifestations and did not improve quality of life despite the absence of significant adverse effects. However, further similar clinical trials are needed to evaluate the efficacy of lidocaine when administered in different dosages and by other means.

Source: Riera et al (2011), "
 
More articles :

» New Study Will Explore Impact of Exercise on Pulmonary Hypertension

For sufferers of Pulmonary Arterial Hypertension (PAH), maintaining healthy heart function isn't as simple as going for a jog every morning. Patients need to do all they can to slow damage to their heart, and exercise can improve potentially improve...

» Crowdsourcing A Cure For Scleroderma

is widely known for medical innovation — from the research laboratory to the patient’s bedside — but in partnership with dedicated donors, the institution is also innovating the way it raises money to accelerate groundbreaking research.With...

» Causes Found for Stiff Skin Conditions

By studying the genetics of a rare inherited disorder called stiff skin syndrome, researchers at the Johns Hopkins University School of Medicine have learned more about , a condition affecting about one in 5,000 people that leads to hardening of the...

» What are the Early Symptoms of Scleroderma?

Scleroderma is a term used to describe a group of rare, chronic diseases characterized by unusual tightening and hardening of the connective tissues and skin. There are two major types of : localized, which only affects the skin; and systemic, which...

» Making A Difference

, a Center for Student Missions team member, recently recounted a touching experience, in which she heard about and met someone with Scleroderma for the very first time. According to Jessica, "We don't always get to see the effect of what it is we...

» Anticoagulation of Systemic Sclerosis Patients In Question

Australia is in a state of ‘clinical equipoise’ over whether to anticoagulate systemic sclerosis patients with pulmonary hypertension, experts say. And with observational studies showing the treatment is associated with a  fivefold...