The Prostaglandin E1 Analog Misoprostol Reduces Symptoms and Microvascular Arteriovenous Shunting in Erythromelalgia: A Double-Blind, Crossover, Placebo-Compared Study

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The Prostaglandin E1 Analog Misoprostol Reduces Symptoms and Microvascular Arteriovenous Shunting in Erythromelalgia : A Double-Blind, Crossover, Placebo-Compared Study

Mørk, Cato (author): Department of Dermatology, Rikshospitalet University Hospital, Norway

Salerud, Göran, 1954- (author): Linköpings universitet,Tekniska högskolan,Biomedicinsk instrumentteknik,Department of Biomedical Engineering, Linköping University

Asker, Claes L, 1966- (author): Karlstads universitet,Institutionen för kemi

Kvernebo, Knut (author): Department of Cardiothoracic Surgery, Ullevaal University Hospital, Norway

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Nature Publishing Group, 2004
2004
English.
In: Journal of Investigative Dermatology. - : Nature Publishing Group. - 0022-202X .- 1523-1747. ; 122:3, s. 587-593

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Journal article (peer-reviewed)

Abstract Subject headings

Based on previous experience with parenteral prostanoids, we studied the effect of misoprostol treatment, an orally administered prostaglandin E1 analog, in patients with erythromelalgia. Treatment with placebo was followed by treatment with misoprostol (0.4–0.8 mg per d), both for 6 wk. The patients (n=21) and a study nurse who administered the trial were blinded. The endpoints were change in pain and need for cooling and global assessment of the treatment. Following central body heat provocation, global skin perfusion, capillary morphology, and change in pain were also recorded before and after each treatment period. Results were compared with data from healthy control subjects (n=11) that did not undergo treatment. Clinical safety and tolerability evaluation included physical examinations, clinical laboratory tests, and monitoring of adverse events. All clinical outcome measures were significantly better after treatment with misoprostol (p<0.01) as compared with placebo treatment and after a 3-mo follow-up without treatment. The heat-induced increase in global perfusion after misoprostol treatment was similar to the control group and significantly lower when compared with baseline (p<0.01) and placebo treatment (p<0.05), respectively. This study demonstrates that misoprostol is clinically superior to placebo in patients with erythromelalgia. The results of the perfusion studies may imply that the mechanism of action of the beneficial effect of misoprostol is reduced microvascular arteriovenous shunting in affected skin.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Dermatologi och venereologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Dermatology and Venereal Diseases (hsv//eng)
NATURVETENSKAP -- Data- och informationsvetenskap -- Datorseende och robotik (hsv//swe)
NATURAL SCIENCES -- Computer and Information Sciences -- Computer Vision and Robotics (hsv//eng)

Keyword

arteriovenous shunting
clinical trial
microcirculation
prostanoids
Dermatology and venerology
Dermatologi och venerologi
MEDICINE
Image analysis
Biomedicinsk lab. Vetenskap

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By the author/editor: Mørk, Cato; Salerud, Göran, ...; Asker, Claes L, ...; Kvernebo, Knut

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Dermatology and ...

NATURAL SCIENCES: NATURAL SCIENCES; and Computer and Inf ...; and Computer Vision ...

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