Abstract

Systemic sclerosis is characterised by ischaemic skin ulcers on the fingertips, and low-energy shock wave therapy is suggested as a novel treatment for ischaemic lesions with angiogenic effects. We aimed to investigate the efficacy and safety of shock wave therapy for skin ulcers in patients with systemic sclerosis. In this phase 3 pivotal study, we analysed 60 systemic sclerosis patients with digital ulcers that did not disappear after >4 weeks of existing treatment: 30 patients were treated with extracorporeal shock wave therapy and 30 with conventional treatment. The ulcer count reduction observed after an 8-week treatment period was compared between the shock wave therapy and conventional treatment groups. After an 8-week treatment period, the mean reduction in the number of ulcers was 0.83 (standard deviation [SD] 2.79) in the conventional treatment group compared to a more pronounced reduction of 4.47 (SD 2.65) in the shock wave therapy group. The study findings indicate the efficacy of extracorporeal shock wave therapy for refractory digital ulcers associated with systemic sclerosis, which has limited therapeutic options. This therapy is non-invasive and safe and can be used without restriction in combination with other therapies, thus serving as a novel therapeutic method.

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