[Evidence-based therapy of Raynaud's syndrome]

Z Rheumatol. 2006 Jul;65(4):285-9. doi: 10.1007/s00393-006-0068-x.
[Article in German]

Abstract

Raynaud's syndrome has a prevalence of 3-5% in the general population. Despite its high frequency, the majority of available therapies have not been validated in randomized controlled trials. Effective therapies with a high level of evidence include the calcium channel blocker nifedipine. As analyzed by meta-analyses, nifedipine showed improvement of the peripheral circulation, as well as reduction of both the intensity and frequency of attacks in patients with primary and secondary Raynaud's syndrome as compared to placebo. Similar results in a metaanalysis were obtained for intravenous infusions of iloprost in patients with secondary Raynaud's phenomenon associated with systemic sclerosis. In addition, intravenous infusions of iloprost improved healing of fingertip ulcers in patients with systemic sclerosis. Therapies with significant effects in single randomized controlled trials include angiotensin II-receptor type 1 antagonists (losartan), the calcium channel blockers felodipine und amlodipine, serotonin-reuptake-inhibitors (fluoxetine) und phosphodiesterase-V-inhibitors (sildenafil, vardenafil). However, the results for these promising substances have to be confirmed in long-term trials with larger patient numbers.

Publication types

  • Review

MeSH terms

  • 3',5'-Cyclic-GMP Phosphodiesterases / antagonists & inhibitors
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Bosentan
  • Calcium Channel Blockers / therapeutic use
  • Cyclic Nucleotide Phosphodiesterases, Type 5
  • Endothelin Receptor Antagonists
  • Epoprostenol / analogs & derivatives
  • Epoprostenol / therapeutic use
  • Evidence-Based Medicine*
  • Humans
  • Phosphodiesterase Inhibitors / therapeutic use
  • Randomized Controlled Trials as Topic
  • Raynaud Disease / diagnosis
  • Raynaud Disease / drug therapy*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Sulfonamides / therapeutic use
  • Vasodilator Agents / therapeutic use*

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Calcium Channel Blockers
  • Endothelin Receptor Antagonists
  • Phosphodiesterase Inhibitors
  • Serotonin Uptake Inhibitors
  • Sulfonamides
  • Vasodilator Agents
  • Epoprostenol
  • 3',5'-Cyclic-GMP Phosphodiesterases
  • Cyclic Nucleotide Phosphodiesterases, Type 5
  • PDE5A protein, human
  • Bosentan