Background Iloprost (Prostacyclin) is effective for resistant Raynaud's phenomenon. We describe our practice of seasonal once monthly infusion which is more cost-effective and flexible than the usual practice of giving iloprost for 3 to 5 days.
Objectives To identify the characteristics, response and tolerance of patients on seasonal monthly infusions of Iloprost from a regional centre in Cannock, United Kingdom.
Methods Retrospective data analysis of patients having monthly iloprost infusions before and during winter for 3–4 months a year (November to February) for resistant Raynaud's phenomenon in 2013 and 2014.
Results There were 72 patients; 57 females and 15 males (F/M =3.8/1), with a mean age of 50.2 (±15.1) years at the start of the iloprost infusion.
Sixty-four patients (88.9%) received calcium channel blockers like nifedipine prior to iloprost and 2 of them also had sildenafil. Thirteen (18.1%) patients had iloprost for 3 to 5 days before switching to seasonal monthly treatment; 8 of them had a digital ulcer or gangrene at presentation. Average follow up was 3.4 (± 2.3) years and mean number of infusions/patient/year was 3.28 ± 0.98.Iloprost improved Raynaud's symptoms in winter in all the patients and was well tolerated by most. Dose adjustment of the iloprost was necessary in 6 (8.3%) patients while 5 (6.9%) of them discontinued due to intolerance.
Conclusions Monthly seasonal iloprost during winter is effective and well tolerated in patients with resistant Raynaud's phenomenon. It is also less expensive than longer courses of iloprost.
Disclosure of Interest None declared