Background: Aminaphtone is a vasoactive drug that was recently demonstrated to improve both peripheral blood perfusion (BP) and clinical symptoms of Raynaud’s phenomenon (RP) in patients with either primary or secondary RP to systemic sclerosis (SSc).^1–2

Objectives: The aim of this study was to evaluate possible interferences of different treatment backgrounds on both skin BP and RP-related clinical symptoms in patients treated with aminaphtone, during a six-month follow-up.

Methods: Forty-six patients with active RP were enrolled during routine clinical assessment after informed consent (11 primary RP, mean age 49±19 SD years, mean RP duration 6±3 years; and 35 secondary RP to systemic sclerosis, mean age 61±17 years, mean RP duration 11±9 years). Aminaphtone was orally administered 75 mg twice daily in addition to current treatments, and all patients were on a stable drug regimen for at least two months, which remained unmodified during the follow-up. All patients were taking cardiaoaspirin. Six groups of treatment backgrounds were identified: 1) no further treatments (12 patients); 2) hydroxychloroquine (2 patients); 3) colchicine (5 patients); 4) methotrexate (3 patients); 5) cyclosporine A (6 patients); 6) mycophenolate (6 patients); 7) proton-pomp inhibitors (12 patients). Blood perfusion was measured by Laser Speckle Contrast Analysis (LASCA)³ at the level of fingertip, periungual areas, dorsum and palm of hands, and face at baseline (T0), after one (T1), four (T4), twelve (T12) and twenty-four (T24) weeks of treatment. Raynaud’s condition score (RCS) and both frequency and duration of Raynaud’s attacks were assessed at the same time. Statistical analysis was performed by non-parametric tests.

Results: During aminaphtone treatment, a progressive statistically significant increase of blood perfusion, as well as an improvement of RP clinical symptoms (decrease of RCS, frequency and duration of RP attacks/day), were observed in all above reported seven groups of RP patients with different treatments backgrounds from T0 to T12 in all skin areas (p<0.01). There were no statistically significant difference between the seven groups of patients concerning skin BP at different times (p=0.60). The results were similar in both primary and secondary (SSc) RP patients (p=0.40). Aminaphtone administration had to be stopped in 2 patients due to headache, and one patient was lost during follow-up.

Conclusions: This study demonstrates that the increase of skin blood perfusion and the improvement of RP clinical symptoms is not influenced by different treatment backgrounds in RP patients treated with aminaphtone. These preliminary results should be further confirmed by a randomised blind clinical trial.

References:

1. Parisi S, et al. Am J Int Med 2015;3;204–9.
2. Sulli A, et al. Arthritis Rheumatol 2017;69:4122.
3. Ruaro B, et al. Ann Rheum Dis. 2014;73:1181–5.

Disclosure of Interest: None declared

DOI: 10.1136/annrheumdis-2018-eular.6401