Treatment of Calciphylaxis with Early or Limited Lesions, or Contraindication to Intravenous Therapy

When calciphylaxis is identified at an early stage with limited lesion extent, or when intravenous therapy cannot be used, a targeted local approach is indicated rather than systemic treatment.

Clinical Scenario

This protocol is for patients with early and limited calciphylaxis lesions, or those with a contraindication to intravenous sodium thiosulfate therapy. In either situation, the systemic route is either unnecessary or not an available option, and an alternative delivery strategy is warranted.

Treatment Approach

The regimen for this scenario uses an intralesional delivery method for sodium thiosulfate — applied directly at the site of disease. This route allows the therapy to be administered locally, avoiding systemic exposure. The complete injection schedule and session parameters are detailed in the full protocol.

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References

DOI: 10.1053/j.ajkd.2022.06.011
However, the adverse effects may be avoided if sodium thiosulfate is administered intralesionally as an alternative strategy for patients with early and limited disease or contraindications to intravenous therapy.
Intralesional injection frequency was variable, ranging from a single injection to an injection every few days; the median quantity of intralesional sodium thiosulfate per injection session was 3.0 mL.

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