Definition
A dubious and confusing disease, scleroderma still catches the attention of many scholars: we are talking about a chronic disease characterized by a gradual thickening of the skin. Scleroderma affects, in particular, the skin of the limbs and mouth, although it can also involve internal organs and tissues, and capillaries.
Causes
Scleroderma is one of the diseases of unknown etiology. Clinical evidence shows that the disease is the result of the accumulation and overproduction of collagen fibers in some tissues of the body. From the current scientific hypotheses, it seems that scleroderma is heavily influenced by the immune system: its alteration, in fact, would induce the cells to synthesize an "abnormal quantity of collagen, which accumulates in the various anatomical sites creating damage.
Symptoms
Symptoms associated with scleroderma include: thickening of the skin of the fingers, hands, arms and face, joint swelling, muscle soreness, hair loss, heartburn with digestive difficulties (stomach scleroderma), shortness of breath (pulmonary scleroderma ), dry eyes, skin lightening / darkening, Raynaud's syndrome (the skin becomes hypersensitive to cold, modulates its natural color) and abnormal cutaneous xerosis.
The information on Scleroderma Stroke - Drugs to Treat Scleroderma is not intended to replace the direct relationship between healthcare professional and patient. Always consult your doctor and / or specialist before taking Scleroderma Shot - Drugs to Treat Scleroderma.
Medicines
Unfortunately, no drug has yet been identified that can effectively and permanently treat scleroderma: however, numerous pharmacological preparations are available that are useful to alleviate the symptoms that distinguish the disease, thus improving the patient's quality of life.
The milder and asymptomatic variants of scleroderma may also not be cured with any drug, although periodic specialist control is required to monitor any progression - in a negative sense - of the disease.
Generally speaking, treatment for scleroderma is always dependent on the severity of the symptoms and the general health of the patient; when the disease goes deep, therefore well beyond the superficial layer of the skin, affecting the tissues and internal organs, it must be constantly kept under control. It should not be forgotten, in fact, that scleroderma, expanding into the heart and lung tissues, it could also kill the victim; clearly, we are talking about extreme cases, but no eventuality can be omitted.
However, it is necessary not to alarm excessively: most scleroderma variants regress with the application of specific ointments or creams, formulated with vitamin D derivatives, and possibly associated with steroid-based ointments that exert their therapeutic effect by counteracting inflammation.
Modern medicine, however, has a large number of drugs, which may be optimal for one form of scleroderma, but which may not be at all for "another variant. Let's start, therefore, to report the most used drugs in therapy, analyzing the individual ones. options.
When the drugs do not bring the desired results, the doctor can offer the patient alternative treatments, such as phototherapy or laser surgery for the removal of irreparably damaged tissue. In cases of extreme severity, amputation or lung transplantation is conceivable.
The following are the classes of drugs most used in therapy against scleroderma, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
NSAIDs: oral administration of non-steroidal anti-inflammatory drugs is indicated to reduce pain associated with scleroderma, as well as to decrease inflammation of the nerves and tendons.
- Naproxen (eg Aleve, Naprosyn, Prexan, Naprius): it is recommended to take the drug at a dosage of 550 mg, orally, once a day, followed by 550 mg of active ingredient every 12 hours; alternatively, take 275 mg of naproxen every 6-8 hours, as needed. Do not exceed 1100 mg per day.
- Ibuprofen (eg. Brufen, Moment, Subitene): the drug reduces the painful sensation in the muscles and promotes the ability to move. To relieve pain associated with scleroderma, it is recommended to take a dose of the drug ranging from 200 to 400 mg, orally, every 4-6 hours, as needed. Do not exceed 400 mg per dose. In some cases, where scleroderma creates intense pain, it is possible to take the drug intravenously (eg Pedea), at the indicative dosage of 400-800 mg over 30 minutes, every 6 hours, as needed.
Other NSAIDs used in therapy to mask pain include: Ketoprofen (eg. Fastum, Ketoprofen ALM, Steofen), Diclofenac (eg. Voltaren), Acetylsalicylic acid (eg. Aspirin, Vivin, Ac Acet, Carin not to be administered to children under the age of 12), etc.
Corticosteroids - these drugs act with a powerful anti-inflammatory effect; when taken systemically, they are indicated to reduce inflammation of the cardiac membrane in the context of heart scleroderma. The administration of steroid drugs is also indicated for muscle and limb scleroderma; these active ingredients must be taken very carefully, considering their conspicuous side effects; for example, scleroderma patients who take these drugs for long periods may observe an increase in blood pressure and a worsening of kidney function.
- Prednisone (eg. Deltacortene, Lodotra): take 5-60 mg of active orally in 1-4 divided doses over 24 hours. Consult your doctor. Do not continue therapy beyond what is necessary.
- Methylprednisolone (eg Advantan, Solu-medrol, Depo-medrol, Medrol, Urbason): to ensure a good anti-inflammatory effect, take 4-48 mg per day of the drug orally.
Cyclophosphamide (eg Endoxan Baxter, bottle or tablets): is an alkylating agent used in therapy in the context of pulmonary scleroderma, in association with corticosteroid drugs: its therapeutic action consists in "weakening the" activity of the immune system. The drug is very powerful, therefore it is recommended to use it under close medical observation. For the posology: consult your doctor.
Potassium aminobenzoate: it seems that the administration of this drug is useful to reduce the symptoms accompanying scleroderma in the context of cystic fibrosis; however, the therapeutic efficacy of this drug is not yet fully demonstrated. The dosage should be carefully established by the doctor. DO NOT take the drug in combination with potassium-sparing diuretics (eg Amiloride, Furosemide, Spironolactone).
Medicines for hypertension: in this category, ACE inhibitors play a prestigious role in the treatment of scleroderma in patients in whom hepatic damage, possible or known, is important.
Diuretic drugs are used in therapy in the context of scleroderma in order to relieve swelling in the hands and feet. The choice of one drug over another depends on the patient's general condition and response to treatment. The following are the most used in therapy: the posology will not be described, given the peculiarity of the disease. The prescription of the dosage is exclusively of medical competence.
- Enalapril maleate (Ex. Converten)
- Lisinopril (e.g. Zestril, Ensor, Nosilix)
- Captopril (eg. Capoten)
Immunosuppressive therapy: This is still an experimental therapy, in which scientists place their hopes in treating severe scleroderma with high doses of stem cells. Immunosuppressive therapy aimed at reducing the symptoms of scleroderma uses the same drugs used in cancer therapy. For example: INTERFERON BETA-1B (eg Betaferon, Rebif, Avonex), interleukin-2 (eg Proleukin). The posology, method of administration and duration of treatment are medical parameters of medical competence.
Bosentan (e.g. Tracleer): this drug is used in therapy for the treatment of symptoms related to scleroderma associated with pulmonary hypertension. It appears that the administration of this active may also alleviate the symptoms of Raynaud's syndrome. Indicatively, for the treatment of scleroderma associated with pulmonary arterial hypertension, it is recommended to take 62.5 mg of the drug, twice a day (preferably in the morning and in the evening, on a full stomach or fasting), for 4 weeks; the maintenance dose suggests taking the product at a dose of 125 mg, twice a day. Consult your doctor before undertaking such therapy.
Among the most recurrent symptoms associated with scleroderma, Raynaud's syndrome is remembered: to alleviate the symptoms - intense cold in the extremities, chromatic alteration of the skin of the hands and feet, tingling, inability to move the fingers due to cold - yes they can put into practice some simple tips: wear thick woolen gloves and socks, wear comfortable shoes, practice constant physical exercise, massage hands and feet.
Penicillin D: the administration of this drug is foreseen in therapy to reduce the activity of the immune system, precisely interfering with the synthesis of collagen. In the light of recent studies, it seems that this antibiotic drug can, in some way, minimize the "thickening of the skin, thus preventing the damage from spreading to the deeper organs. In practice, however, it appears that the desired and long-awaited results are not so immediate; It should also be remembered that excessive use of this drug can promote severe kidney disorders and also damage blood cells. Penicillin D is, to date, a drug used as a second choice for the treatment of scleroderma.
Other possible drugs used in therapy to minimize scleroderma symptoms:
- calcitriol (derivative of vitamin D), eg. Rocaltrol
- prostaglandin agonists
- thalidomide
It is therefore not possible to speak of a real cure for scleroderma: numerous drugs available, all aimed at minimizing the damage created by the disease, but none able to cure it completely. Modern Research is encouraging fundraising aimed at identifying which drug is the most suitable for the treatment of scleroderma.
