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 :

» Role of N-terminal Brain Natriuretic Peptide in Scleroderma-associated Pulmonary Arterial Hypertension

Mark H. Williams, Clive E. Handler, Raza Akram, Colette J. Smith, Clare Das, Joanna Smee, Devaki Nair, Christopher P. Denton, Carol M. Black and John G. CoghlanFirst published online: April 27, 2006Source:

» Joint Involvement And Aggressive Systemic Sclerosis

Clinical joint involvement is strikingly common in patients with systemic sclerosis () and is associated with a more active and severe disease phenotype, according to an analysis of the world’s largest systemic sclerosis (SSc) registry. proved to...

» UT Researchers At Forefront Of Efforts To Stem The Tide Of Autoimmune Diseases

Autoimmune and autoinflammatory diseases are on the rise and researchers and physicians at are at the forefront of efforts to stem the tide. These diseases are often hard to diagnose and often affect individuals differently.Autoimmune and...

» The Science of Raw Food

In a recent article on , we noted that changing your diet and introducing an abundance of living and raw foods provide a much safer alternative than traditional medicine in restoring the body’s alkalinity, and subsequently ensuring good health....

» 1st Systemic Sclerosis World Congress

The world's very first Systemic Sclerosis World Congress is to be held in Florence, Italy, next week from February 11-13th 2010. Carded primarily as an interdisciplinary conference for cardiologists, dermatologists, nephrologists, pulmonologists and...

» Endothelin Receptor Antagonists for the Treatment of Raynaud’s Phenomenon and Digital Ulcers in Systemic Sclerosis

Kait Arefiev, David F. Fiorentino, and Lorinda ChungDivision of Immunology and Rheumatology, Departments of Dermatology and Medicine, Stanford University School of Medicine, Palo Alto VA Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304,...