Elling, T. (Tessa) (2018) Intravenous prostacyclin analogues in the treatment of Raynaud’s Phenomenon in the long-term use. thesis, Medicine.
Full text available on request.Abstract
Introduction Intravenous prostacyclin analogues are used for the treatment of Raynaud’s Phenomenon (RP) in patients with no response to oral drug therapies. However, few studies evaluated the effects of intravenous prostacyclin analogues on RP in the long-term use, in which robust results are missing. Nonetheless, the high costs, frequent hospitalization and possible side-effects of prostacyclin analogues makes a structural evaluation of this treatment necessary. This study evaluated the evidence of various treatment regimens and the effects of intravenous prostacyclin analogues on health-related quality of life (HRQoL), RP symptoms and blood perfusion in chronically treated patients. Methods: In this cross-sectional study, HRQoL was analysed in 19 patients treated with a prostacyclin analogue due to severe RP, compared to healthy controls (n=19) and patients with RP without prostacyclin analogue treatment (n=19). The RP symptoms (i.e. severity, frequency and duration of RP attacks) were reported in daily diaries before and after treatment (n=11). Blood perfusion was assessed with photoelectric plethysmography on the fingers during a cooling and recovery test, directly before and after the infusion (n=10). Mean ischemic time was defined as the time between loss and gain of perfusion for the five fingers. Ultimately, a structured review of literature was performed in PubMed to identify evidence for various treatment protocols. Results: A significantly impaired HRQoL was observed in almost all domains, compared to healthy controls (p<0.05). Compared to patients with RP without prostacyclin treatment, a significantly impaired HRQoL was seen in the domains ‘social functioning’ and ‘general health’, together with an improvement in the domain ‘emotional well-being’ (p<0.05). In contrast to literature, in which various treatment schedules seems to be effective in the long-term use, the current study showed minimal to no differences in RP symptoms and mean ischemic time, before and after infusion. Conclusion This study suggests minimal effect of intravenous prostacyclin analogues on HRQoL, RP symptoms and digital blood flow. These results advocate for a careful evaluation of prostacyclin analogues in chronically treated patients.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Mulder, Dr. D.J. and Second supervisor: and Eman - Abdulle, Drs. A. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:50 |
| Last Modified: | 25 Jun 2020 10:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1094 |
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