Abstract
Phosphodiesterase inhibitors (such as sildenafil) and endothelin receptor antagonist, bosentan, are effective for digital ulcer disease in systemic sclerosis (SSc-DU) and are endorsed in international treatment recommendations. Commissioning of high-cost drugs, such as bosentan, however, differs across devolved nations of the UK. We report a multicentre service evaluation project to examine ‘real world’ management of SSc-DU before and following the 2015 UK Scleroderma Study Group (UKSSG) guidance, across southwest (SW) England and Wales. Results showed that iloprost and sildenafil use for SSc-DU was higher in patients in Wales prior to 2015. Between 2015–2017, sildenafil use for SSc-DU increased in SW England while remaining stable in Wales. Bosentan use for SSc-DU after 2015 in SW England increased, while remaining stable and proportionately lower in Wales. These findings demonstrate that differing commissioning guidance across devolved nations of the UK seems to contribute to geographic variation in patient care.
| Original language | English |
|---|---|
| Article number | CM-2020-0031 |
| Pages (from-to) | 343-345 |
| Journal | Clinical Medicine |
| Volume | 20 |
| Issue number | 3 |
| Early online date | 15 May 2020 |
| DOIs | |
| Publication status | Published - 31 May 2020 |
Bibliographical note
Funding Information:Dr Pauling reports research grants, personal fees and non-financial support from Actelion Pharmaceuticals. Dr Pauling also reports personal fees from Boehringer Ingelheim and from Sojournix Pharma outside of the submitted work. Dr Reilly undertook this service evaluation project during an out-of-programme experience (OOPE) supported, in part, with an unrestricted research grant from Actelion Pharmaceuticals.
Funding Information:
This work was supported by an unrestricted research grant from Actelion Pharmaceuticals.
Keywords
- Digital ulcer
- Endothelin receptor antagonist
- Phosphodiesterase inhibitors
- Scleroderma
- Systemic sclerosis
ASJC Scopus subject areas
- General Medicine