The United States has recently approved the first medication to treat severe frostbite, known as iloprost. Frostbite, which primarily affects extremities like fingers, toes, noses, and ears, can lead to tissue death and require amputation. People who are regularly exposed to cold temperatures, such as mountain climbers, military personnel, and homeless individuals, are at a higher risk of developing severe cases of frostbite. Iloprost, a synthetic drug developed in the 1980s, works as a vasodilator, widening blood vessels, improving blood flow, and preventing blood clotting. It was initially used to treat Raynaud’s disease and blood pressure-related conditions.
Research on iloprost’s effectiveness in treating frostbite began in 1994, and subsequent studies in England, France, and Nepal showed promising results. In a clinical trial cited by the FDA, patients treated with iloprost had a significantly lower rate of amputations compared to other treatments. The drug has been an approved treatment for frostbite in many European countries for years. Vascular surgeon Chris Imray, who has been using iloprost for over a decade, explains the process of how frostbite affects the body and how iloprost works to prevent tissue damage and amputations.
Iloprost works by dilating blood vessels, enhancing blood flow, and improving oxygen delivery to damaged tissues. By administering iloprost intravenously, vascular surgeons can effectively treat severe frostbite, avoiding the need for procedures like sympathectomy. The drug is administered at gradually increasing doses for several days, allowing surgeons to salvage nearly dead tissues and restore limb function. Iloprost’s mechanisms of action include vasodilation, slight anticoagulant effects, and improved red blood cell function in small blood vessels.
Timing is crucial when treating frostbite with iloprost, as faster intervention leads to better outcomes. The drug’s approval will benefit high-profile climbers who are at risk of frostbite injuries on expeditions, as well as homeless individuals who may also suffer from severe frostbite but receive less attention. The availability of iloprost treatment close to mountainous regions can provide quick access to care for frostbite patients, preventing life-altering amputations. Overall, the approval of iloprost in the United States is a significant advancement in frostbite treatment that will transform care for those at risk of losing limbs due to severe frostbite injuries.
