AB0814 Sodium thiosulfate 10% intralesional to treat calcinosis in patients with systemic sclerosis and dermatomyositis: case series. (12th June 2018) - Tonial, A.F.
Abstract : Background: Calcinosis is a frequent complication of systemic sclerosis and dermatomyositis, causing local pain, joint mobility reduction, ulcerations, secondary infections and disability. Currently, there is no effective treatment to calcinosis, but the use of topical dressing or intralesional sodium thiosulfate (STS) has showed promising results. Objectives: To evaluate efficacy of intralesional STS 10% in calcinosis of patients with dermatomyositis and systemic sclerosis. Methods: Prospective and open-labbed study including dermatomyositis and systemic sclerosis patients with calcinosis. The primary endpoints were: pain relief evaluated through visual analogue scale (VAS) and reduction of major diameters of calcinosis in x-ray. The secondary endpoints were: improvement in the quality of life and function evaluated by SF12 and HAQ respectively. Results: A total of 10 calcinosis from 7 patients, one with dermatomyositis and 6 with systemic sclerosis were treated. The average dosage of STS per aplication was 9.27 mg at intervals ranging between 15 and 30 days (mean=17.85) between each injection. The number of injections per each calcinosis ranged between 3 and 8 (mean 3.3). All patients reported improvements in pain, however the results were not statistically significant (table 1). There were no reductions in calcionosis diameters, nor improvement of quality of life and function. Conclusions: Low doses of sodium thiosulfate applied through intralesional injections, in a restrict number of applications and long intervals were not effective to treat calcinosis. References: [1] Baumgartner-Nielsen J, Olesen AB. Treatment of skin calcification with sodium thiosulfate: a case series. Acta Derm Venereol2016; 96: 257–258. [2] Goossens J, Courbebaisse M, Caudron E, et al. Efficacy of intralesional sodium thiosulfate injections for disabling tumoral calcinosis: Two cases. Semin Arthritis Rheum. 2017;47(3):451–455. [3] Noureddine L, Landis M, Patel N, et al. Efficacy of sodium thiosulfate for the treatment for calciphylaxis. Clin Nephrol. 2011;75(6):485–90. [4] Smith JP. Intradermal sodium thiosulfate for exophytic calcinosis cutis of connective tissue disease. J Am Acad Dermatol2013; 69:146–7. [5] Bienvenu B. Treatment of subcutaneous calcinosis in systemic disorders. Rev Med Interne. 2014; 35(7):444–52. Disclosure of Interest: None declared