A higher degree of criticism about the effectiveness of bosentan for digital ulcers in scleroderma patients, as for interstitial disease, is also necessary: Comment on the article by Seibold et al

摘要

To the Editor:In a recent article, Seibold et al report a randomized controlled trial (RCT) showing negative results of the use of bosentan in systemic sclerosis (SSc)-related pulmonary fibrosis (1). However, 2 double-blind RCTs (the Randomized Placebo-Controlled Study on the Prevention of Ischemic Digital Ulcers in Scleroderma [RAPIDS-1 and RAPIDS-2]) with similar designs conducted by the same group of authors (2,3) demonstrated the efficacy of bosentan for the prevention of digital ulcers in SSc patients. Since then, bosentan has been considered a useful therapy and even a new hope for the prevention of digital ulcers, and is approved for this indication in Europe (4).