Document Detail

Effects of micronutrient antioxidants (alpha-tocopherol and ascorbic acid) on skin thickening and lung function in patients with early diffuse systemic sclerosis.
MedLine Citation:
PMID:  20309694     Owner:  NLM     Status:  MEDLINE    
To assess the effects of alpha-tocopherol and ascorbic acid on skin thickening and lung function in patients with early diffuse systemic sclerosis (SSc), thirteen patients with early diffuse SSc, with positive anti-topoisomerase-I antibody, high skin thickening progression rate (STPR ≥ 12/year) and decreased lung diffusing capacity (DLCO ≤ 75%) were included in this study. Patients were randomized into two subgroups: Subgroup A-six patients, treated with intravenous cyclophosphamide (CyP) (500 mg/m(2) of body surface monthly) and antioxidants (alpha-tocopherol 400 IU/day and ascorbic acid 1,000 mg/day), and Subgroup B-seven patients, who received CyP without antioxidants. In both subgroups, effects of treatment on skin thickening and lung function were evaluated by comparison of the modified Rodnan skin score (MRSS), STPR, forced vital capacity (FVC), transfer-factor (DLCO) and diffusing coefficient for carbon monoxide (DLCO/VA) at baseline and 1 month after the sixth pulse of CyP. The mean MRSS did not change from baseline to the end of the follow-up in subgroup A (15.7 vs. 16.4, P = 0.50), but it increased significantly in subgroup B (17.9 vs. 23.6, P = 0.03). Although the mean STPR decreased notably in both subgroups of patients (in subgroup A-from 18.9/year to 2.2/year, P = 0.03, and in subgroup B-from 17.5/year to 8.6/year, P = 0.03), the mean STPR at the end of the treatment period was significantly lower in subgroup A (2.2/year vs. 8.6/year, P = 0.04). The mean value of FVC did not change either in subgroup A (91.0-87%, P = 0.2) or in subgroup B (from 101.2 to 99.7%, P = 0.7). Parameters of lung diffusing capacity improved somewhat in subgroup A (DLCO from 55.7 to 62.0% and DLCO/VA from 68.7 to 74.2%) and decreased in subgroup B (DLCO from 66.2 to 60.6% and DLCO/VA from 76.9 to 71.6%), but differences were not statistically significant. After 6 months of therapy, patients treated with CyP and antioxidants had a significantly lower STPR, compared to patients treated with CyP only. Lung function parameters remained stable in both subgroups. However, lung diffusing capacity improved slightly, without statistical significance, in patients treated with CyP and antioxidants, and it deteriorated in patients without antioxidants.
Predrag Ostojic; Nemanja Damjanov
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2010-03-23
Journal Detail:
Title:  Rheumatology international     Volume:  31     ISSN:  1437-160X     ISO Abbreviation:  Rheumatol. Int.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-25     Completed Date:  2011-12-07     Revised Date:  2012-02-06    
Medline Journal Info:
Nlm Unique ID:  8206885     Medline TA:  Rheumatol Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1051-4     Citation Subset:  IM    
Istitute of Rheumatology, University of Belgrade, Resavska 69, Belgrade, Serbia. ostojic@net.yu
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MeSH Terms
Antioxidants / therapeutic use*
Ascorbic Acid / therapeutic use*
Cyclophosphamide / therapeutic use
Drug Therapy, Combination
Immunosuppressive Agents / therapeutic use
Injections, Intravenous
Lung / drug effects*,  physiopathology
Middle Aged
Pulmonary Diffusing Capacity / drug effects,  physiology
Scleroderma, Diffuse / drug therapy*,  pathology,  physiopathology
Skin / drug effects*,  pathology
alpha-Tocopherol / therapeutic use*
Reg. No./Substance:
0/Antioxidants; 0/Immunosuppressive Agents; 50-18-0/Cyclophosphamide; 50-81-7/Ascorbic Acid; 59-02-9/alpha-Tocopherol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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