Abstract
Thromboangiitis obliterans (TAO) is a vascular disease that affects small and medium-sized arteries and veins of both upper and lower extremities. Distal ischaemic lesions and digital necrotic ulcers, as well as major amputation rates, among these patients are not negligible. So far, no treatment option has been demonstrated to be completely effective for this disease. Endothelin-1 (ET-1) has been increasingly associated to vascular damage. Furthermore, elevated levels of ET-1 have been proved in TAO patients. Thus, ET-1 receptor antagonists may be considered as a treatment option in this disease.
Consistently, initial results from open-label studies or case reports show promising efficacy of bosentan for treatment and prevention of digital ulcers in TAO with a favourable safety profile. In any case, bosentan should be further investigated in TAO patient management. To confirm initial promising findings, larger controlled randomised trials with a control group are needed. In the meantime, bosentan should be considered as a hopeful investigational agent for treating these patients.
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