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The Prostaglandin E1 Analog Misoprostol Reduces Symptoms and Microvascular Arteriovenous Shunting in Erythromelalgia - A Double-Blind, Crossover, Placebo-Compared Study
2004 (English)In: Journal of Investigative Dermatology Volume 122, Issue 3, Page 587-593, Mar 2004Article in journal (Refereed)
Abstract [en]

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 (0.40.8 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 signifcantly 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 signiÞcantly 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 beneÞcial effect of misoprostol is reduced microvascular arteriovenous shunting in affected skin

Place, publisher, year, edition, pages
Keyword [en]
arteriovenous shunting, clinical trial, microcirculation, prostanoids, video microscopy, laser doppler imaging
URN: urn:nbn:se:kau:diva-24700OAI: diva2:598470
Available from: 2013-01-22 Created: 2013-01-22 Last updated: 2014-10-28

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Asker, Claes

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