Background/Purpose: Aminaphtone is an oral vasoactive drug used to treat microvascular impairement since 30 years, and recently suggested to down-regulate endothelin-1 production by endothelial cells, and to improve Raynaud’s phenomenon (RP) symptoms (1-3). Laser speckle contrast analysis (LASCA) is a validated technique to measure skin blood perfusion (4,5). The aim of this longitudinal study was to evaluate skin blood perfusion changes and clinical symptoms during aminaphtone treatment in patients affected by RP.

Methods: Thirty-seven patients with active RP were enrolled during routine clinical assessment in November 2015: 10 primary (PRP) and 27 secondary RP (SRP) to systemic sclerosis. Aminaphtone was administered as clinical practice 75 mg twice daily (off label) in addiction to current treatments (patients were on stable drug regimen from at least two months, and they did not modify it during follow-up). Blood perfusion was measured by LASCA as perfusion units (PU) at baseline (T0), after one (T1), four (T4) and twelve weeks (T12) of treatment, at the level of fingertips, periungual areas, dorsum and palm of hands, tip of noise, zygoma, forehead, and perioral regions. Raynaud condition score (RCS) and both Raynaud’s attack frequency and duration were also assessed at the same times. Statistical analysis was performed by non-parametric tests.

Results: A progressive statistically significant increase of blood perfusion was observed from T0 to T12 in all skin areas as in PRP as in SRP patients (median PU at T0, T1, T4, T12 respectively: fingertips 52, 86, 92, 104 for PRP, and 53, 91, 102, 107 for SRP; periungual areas 50, 74, 90, 91 for PRP, and 42, 80, 90, 91 for SRP; dorsum of hands 42, 59, 69, 75 for PRP, and 33, 66, 74, 78 for SRP; palm of hands 54, 76, 87, 101 for PRP, and 57, 88, 98, 97 for SRP; whole face 120, 125, 142, 150 for PRP, and 127, 128, 144, 148 for SRP; p<0.001 for all). In particular, all patients treated with aminaphtone showed an increase of blood perfusion from T0 to T1, and 28 out of 35 patients from T1 to T12 had a further increase of blood perfusion. A progressive statistically significant decrease of RCS (median at T0, T1, T4, T12: 7, 5, 4, 4 for PRP, and 8, 6, 4, 3 for SRP; p<0.0001), Raynaud frequency (median at T0, T1, T4, T12: 2, 2, 1, 1 for PRP, and 2, 2, 1, 1 for SRP attacks/day; p<0.0001) and duration (median at T0, T1, T4, T12: 20, 20, 10, 7 for PRP, and 20, 20, 10, 4 for SRP minutes; p<0.0001) was also observed from T0 to T12. The results were similar for both primary and secondary RP. Two patients had to stop the drug due to headache, and one patient was lost during follow-up.

Conclusion: This study demonstrates that aminaphtone treatment increases in short-time skin blood perfusion, as well as seems to ameliorate RP symptoms. A randomized clinical trial including larger number of control subjects need to confirm these results and to assess the possible role of aminaphtone in the treatment/prevention of systemic sclerosis related clinical complicantions. References. 1. Parisi S, et al. Am J Int Med 2015;3;204-9. 2. Scorza R, et al. Drugs R D 2008;9:251-7. 3. Salazar G, et al. Eur J Pharmacol. 2016;782:59-69. 4. Ruaro B, et al. Ann Rheum Dis. 2014;73:1181-5. 5. Ruaro B, et al. Microvasc Res. 2016;105:119-24.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/aminaphtone-treatment-increases-skin-blood-perfusion-and-related-clinical-symptoms-in-patients-affected-by-raynauds-phenomenon-a-pilot-study-based-on-laser-speckle-contrast-analysis/