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 :

» Systemic Sclerosis: An Update

Systemic sclerosis (SSc) is a clinically heterogeneous, systemic disorder affecting connective tissue of skin, internal organs, and walls of blood vessels. It is characterized by alterations of the microvasculature in the form of hypoxia, digital...

» Study Suggests Link Between Scleroderma, Cancer in Certain Patients

Patients with a certain type of may get cancer and scleroderma simultaneously, Johns Hopkins researchers have found, suggesting that in some diseases, autoimmunity and cancer may be linked.These findings could lead researchers closer to discovering...

» Researchers Find Small Group Of ANA & RP Negative Patients

There exists a very small subgroup of patients with (SSc) who lack circulating (ANA) and who do not have Raynaud's phenomenon (RP), research shows. These patients also fail to meet any of the diagnostic criteria for known SSc mimics.The...

» Unite Against Scleroderma A Great Success

Our very first Scleroderma Awareness Walk, "Unite Against Scleroderma" was a great success. Sunday May 1st was a dream that became a reality, simply because family and friends of the Foundation also wanted the community of Trinidad and Tobago to be...

» Do You Need To Alter Your Diet?

According to Chrissy Carroll, a registered dietitian and certified personal trainer with the , Scleroderma can present differently in each affected person, and diet recommendations are typically targeted toward specific symptoms. She indicated that...

» Cytokines in Systemic Sclerosis: Focus on IL-17

Julie Baraut, Dominique Farge, Elena Ivan-Grigore, Franck Verrecchia, and Laurence MichelSystemic sclerosis (SSc) is an autoimmune disease characterized by progressive sclerosis of the skin and internal organ dysfunction. Cytokine production and...