Barnidipine as a potential alternative treatment for Raynaud's phenomenon secondary to systemic sclerosis: a retrospective pilot study

期刊论文
发表日期：

2024年12月9日

查看全文

Riccardo Bixio,
Francesca Mastropaolo,
Matteo Appoloni,
Davide Bertelle,
Eugenia Bertoldo,
Andrea Morciano,
Stefano Di Donato,
Giovanni Adami,
Ombretta Viapiana,
Maurizio Rossini,
Idolazzi Luca

摘要

Objectives

To assess short-term barnidipine efficacy and tolerability on Systemic Sclerosis (SSc)-Raynaud’s phenomenon (RP).

Methods

We retrospectively evaluated patients with SSc starting barnidipine 10 mg/day. Raynaud’s Condition Score (RCS) and mean blood pressure (MBP) were assessed at baseline and 6-month follow-up. Discontinuation rates and adverse events (AEs) were compared with retrospectively evaluated patients who started MR-nifedipine 20 mg/day at our centre.

Results

Sixty-four patients (29 barnidipine, 35 MR-nifedipine) were evaluated. Most patients starting barnidipine had a previous CCB exposure (69%; 57.9% of these were withdrawn for AEs). During follow-up, RCS decreased significantly (6.6 ± 1.8 vs 4.4 ± 1.8, p < 0.001), while the MBP did not change significantly (86.4 ± 8.4 vs 85 ± 7.3 mmHg; p = 0.36). Nine patients (31%) discontinued barnidipine during the follow-up (AEs 6/9, inefficacy 3/9). Previous CCB failure did not predict barnidipine withdrawal (OR = 0.188 95%CI [0.02–1.8]; p = 0.147). No predictors of barnidipine withdrawal were found, and no clinical or demographic differences were found between patients withdrawing and continuing barnidipine. The 6-month retention rates of barnidipine and MR-nifedipine did not differ significantly (69 vs 80%; log-rank p = 0.23), and the two groups had a similar incidence of AEs leading to discontinuation (20.1 vs 17%; p = 0.48).

Conclusions

Barnidipine could be an effective and well-tolerated therapeutic option to treat SSc-RP, even in patients previously failing other CCBs.

Key Points

• Calcium channel blockers (CCBs) currently represent the first-line treatment for Raynaud’s phenomenon secondary to Systemic Sclerosis (SSc-RP). However, little data exists about using novel CCBs, such as barnidipine, in this condition.

• This study retrospectively evaluated patients with SSc-RP treated with barnidipine to assess its short-term efficacy. To serve as a control group for tolerability, we retrospectively compared these patients with others starting modified release-nifedipine (MR-nifedipine).

• In patients treated with barnidipine, we observed a significant decrease in Raynaud’s condition score at the 6-month follow-up without substantial changes in mean blood pressure.

• The proportion of adverse events and drug withdrawal rate between patients starting barnidipine and MR-nifedipine did not differ significantly, even in patients starting barnidipine after previously failing other CCBs.