Treatment of calcinosis with diltiazem

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Abstract
Objective. To test the hypothesis that the calcium antagonist diltiazem is effective in the treatment of calcinosis. Methods. Diltiazem, 240–480 mg/day, was given to 4 patients with idiopathic or CREST‐related (calcinosis, Raynaud'S phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias) calcinosis for 1–12 years. Serial radiographs of the affected areas, using identical technique, and clinical evaluations were obtained. A fifth patient, who did not tolerate diltiazem, received verapamil, 120 mg/day for 18 months. Results. All patients taking diltiazem had a reduction or disappearance of the calcific lesions, with striking clinical improvement. One patient'S case was followed for 12 years. The response to diltiazem during the first 5 years of treatment has been previously reported in detail; however, over 7 years of additional treatment, there was further reduction of the lesions. One patient developed a large calcific lesion while receiving verapamil for hypertension, and after verapamil was replaced with diltiazem, there was a dramatic response. Verapamil was ineffective in the fifth patient, who did not tolerate diltiazem. Conclusion. Long‐term treatment with diltiazem, but not verapamil, is effective in calcinosis.