Bosentan and digital ulcers

Digital ulcers are one of the most painful, disabling and challenging complication of systemic sclerosis. In two large randomized placebo-controlled studies, the non selective inhibitor of endothelin-1, bosentan, used at a daily dose of 250mg, showed a significant preventive effect on the occurrence of new digital ulcers, which incidence was reduced by 30 to 50%. This effect is associated to an improvement of pain and hand disability scales. These results yield an agreement of the EMEA for this indication, which will be restricted to most severe cases. (C) 2007 Elsevier SAS. Tous droits reserves.