Pilot studies demonstrate the potential benefits of antiinflammatory therapy in human lymphedema Journal Article
| Authors: | Rockson, S. G.; Tian, W.; Jiang, X.; Kuznetsova, T.; Haddad, F.; Zampell, J.; Mehrara, B.; Sampson, J. P.; Roche, L.; Kim, J.; Nicolls, M. R. |
| Article Title: | Pilot studies demonstrate the potential benefits of antiinflammatory therapy in human lymphedema |
| Abstract: | BACKGROUND: Lymphedema is a common condition affecting millions around the world that still lacks approved medical therapy. Because ketoprofen, an NSAID, has been therapeutic in experimental lymphedema, we evaluated its efficacy in humans. METHODS: We first performed an exploratory open-label trial. Patients with either primary or secondary lymphedema received ketoprofen 75 mg by mouth 3 times daily for 4 months. Subjects were evaluated for changes in histopathology, with skin thickness, limb volume, and tissue bioimpedance changes serving as secondary endpoints. Based on our encouraging findings, we next conducted a placebo-controlled trial, with the primary outcome defined as a change in skin thickness, as measured by skin calipers. Secondary endpoints for this second study included histopathology, limb volume, bioimpedance, and systemic inflammatory mediators. RESULTS: We enrolled 21 lymphedema patients in the open-label trial, from November 2010 to July 2011. Histopathology and skin thickness were significantly improved at 4 months compared with baseline. In the follow-up, double-blind, placebo-controlled trial, we enrolled 34 patients from August 2011 to October 2015, with 16 ketoprofen recipients and 18 placebo-treated subjects. No serious adverse events occurred. The ketoprofen recipients demonstrated reduced skin thickness, as well as improved composite measures of histopathology and decreased plasma granulocyte CSF (G-CSF) expression. CONCLUSION: These 2 exploratory studies together support the utility of targeted antiinflammatory therapy with ketoprofen in patients with lymphedema. Our results highlight the promise of such approaches to help restore a failing lymphatic circulation. TRIAL REGISTRATION: ClinicalTrials.gov NCT02257970. |
| Keywords: | inflammation; cardiovascular disease; lymph; eicosanoids; vascular biology |
| Journal Title: | JCI Insight |
| Volume: | 3 |
| Issue: | 20 |
| ISSN: | 2379-3708 |
| Publisher: | Amer Soc Clinical Investigation Inc |
| Date Published: | 2018-10-18 |
| Start Page: | e123775 |
| Language: | English |
| DOI: | 10.1172/jci.insight.123775 |
| PUBMED: | 30333315 |
| PROVIDER: | scopus |
| PMCID: | PMC6237444 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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