Background/Purpose: Assessing the effect of Diltiazem gel on healing process of scleroderma digital ulcers and comparing its effect with Nitroglycerin ointment and placebo.

Methods: Ninety scleroderma patients divided to three groups underwent a single blind randomized clinical trial. Experimental group 1 received Diltazem gel 2%, experimental group 2 received Nitroglycerin ointment 2% and control group received Vaseline as placebo. All interventions were applied 2 times per day for 8 weeks. The mean of maximum diameters of the ulcers was measured for each patient at the beginning and at the end of the study. The site of the ulcers and the number of new ones were, also, determined for each patient.

Results:

The mean diameter of the ulcers at the end of the study was significantly lower in three studied groups compared to the beginning of the study (Diltiazem P<0.001, Nitroglycerin P= 0.002 and Control P= 0.027). However, the difference in size of the ulcers was significantly higher in diltiazem group compared to nitroglycerin and placebo (P= 0.04), especially, in ulcers at distal part of digits (P=0.32). In addition, number of new ulcers did not differ significantly between three groups. Moreover, nitroglycerin ointment (42%) was found to induce more complications for patients compared to Diltiazem gel (28%) and placebo (28%).

Conclusion: Diltiazem gel can be an effective topical therapy with lower complications for treating scleroderma digital ulcers compared to nitroglycerin ointment and placebo.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/diltiazem-gel-as-a-new-local-treatment-for-scleroderma-digital-ulcers/