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Effect of Sildenafil on digital ulcers in systemic sclerosis – analysis from a single centre pilot study
  1. Claudia S. Brueckner1,
  2. Mike O Becker2,
  3. Thomas Kroencke3,
  4. Doerte Huscher4,
  5. Hans Ulrich Scherer2,
  6. Margitta Worm2,
  7. Gerd R Burmester2,
  8. Gabriela Riemekasten5,*
  1. 1 Charité Iniversitätsmedidzin, Germany;
  2. 2 Charité Universitätsmedizin, Germany;
  3. 3 Charité Univrsitätsmedizin, Germany;
  4. 4 German Rheumatology Research Centre, Germany;
  5. 5 Charité University Hospital, Germany
  1. Correspondence to: Gabriela Riemekasten, Rheumatology, Charité University Hospital, Dept of Rheumatology and Clinical Immunology, Charité University Hospital, D-10117 Berlin, Berlin, 10117, Germany; gabriela.riemekasten{at}


Objective: In this pilot study, the effect of sildenafil on digital ulcer (DU) healing and related clinical symptoms was analysed.

Methods: 19 systemic sclerosis (SSc) patients were treated with maximally tolerated sildenafil doses up to 6 months. Primary outcome was the healing of DU. Furthermore, changes in other clinical symptoms were evaluated.

Results: 49 DU were present at baseline that decreased to 17 ulcers (p < 0.001) at the end of sildenafil therapy. Furthermore, the visual analogue scale score for Raynaud’s phenomenon (RP), pain, and activity improved (p = 0.003, p = 0.002, and p = 0.05, respectively). Nine patients developed 12 new DU during sildenafil therapy.

Conclusions: This study indicates an effect of sildenafil on DU healing in SSc patients, improvement of RP and associated symptoms that should be validated in controlled studies.

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