A Double-blind Study of Prazosin in the Treatment of Raynaud's Phenomenon in Scleroderma

Surwit, Richard S.

doi:10.1001/archderm.1984.01650390051010

Cited by 41 publications

(2 citation statements)

References 7 publications

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“…During the taskforce meeting, one of the members (IV) shared limited experience with hyperbaric chamber treatments in patients with CTD-associated DUs, which may be considered as a last resort to be offered to the patient. Regarding other treatments, namely botulinum toxin injections 54,55 and prazosin 56,57 for RP, as well as regional grafting of autologous adipose tissue 58 and vitamin E gel 59 for DUs, the task force opted not to provide specific recommendations due to the lack or absence of experience in clinical practice. Lastly, the task force considered that evidence and expert experience do not favour the use of ischemic preconditioning for the management of CTD-associated RP or DUs.…”

Section: -Other Non-pharmacological Interventions Might Be Considered...mentioning

confidence: 99%

Portuguese Recommendations for the management of Raynaud’s phenomenon and digital ulcers in systemic sclerosis and other connective tissue diseases

Santiago,

Duarte,

Sepriano

et al. 2024

ARP Rheumatol

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Objective: To develop evidence-based recommendations for the non-pharmacological and pharmacological management of Raynaud’s phenomenon (RP) and digital ulcers (DUs) in patients with systemic sclerosis and other immune- mediated connective tissue diseases (CTDs). Methods: A task force comprising 21 rheumatologists, 2 surgeons (vascular and plastic), 2 nurses, and 1 patient representative was established. Following a systematic literature review performed to inform the recommendations, statements were formulated and discussed during two meetings (one online and one in-person). Levels of evidence, grades of recommendation (GoR), and level of agreement (LoA) were determined. Results: Five overarching principles and 13 recommendations were developed. GoR ranged from A to D. The mean ± standard difference (SD) LoA with the overarching principles and recommendations ranged from 7.8±2.1 to 9.8±0.4. Briefly, the management of RP and DUs in patients with CTDs should be coordinated by a multidisciplinary team and based on shared decisions with patients. Nifedipine should be used as first-line therapy for RP and/ or DUs. Sildenafil, tadalafil, and/or iloprost IV are second-line options for severe and/or refractory patients with RP and/or DUs. Sildenafil, tadalafil and/or Iloprost IV, should be prescribed for healing and prevention (also including bosentan) of DUs. In patients with RP and/or DUs, non-pharmacological interventions might be considered as add-ons, but there is limited quality and quantity of scientific evidence supporting their use. Conclusions: These recommendations will inform rheumatologists, specialist nurses, other healthcare professionals, and patients about a comprehensive and personalized management of RP and DUs. A research agenda was developed to address unmet needs, particularly for non-pharmacologic interventions.

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Section: -Other Non-pharmacological Interventions Might Be Considered...mentioning

confidence: 99%

Portuguese Recommendations for the management of Raynaud’s phenomenon and digital ulcers in systemic sclerosis and other connective tissue diseases

Santiago,

Duarte,

Sepriano

et al. 2024

ARP Rheumatol

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“…Due to the absence of significant systemic hypotension, fluoxetine can be helpful in patients who are particularly prone to vasodilatory side effects. There is limited evidence that prazosin (an alpha blocker) is modestly effective for RP, with few studies showing that it decreases the frequency of the attacks; however, side effects were not uncommon and benefits were short-lived [48][49][50][51].…”

Section: Phosphodiesterase Type-5 Inhibitorsmentioning

confidence: 99%

Practical management of Raynaud's phenomenon – a primer for practicing physicians

Ramahi

Hughes

Khanna

2022

Current Opinion in Rheumatology

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Purpose of reviewRaynaud's phenomenon (RP) is a common vasospastic condition that results in digital hypoperfusion in response to cold and/or emotional stress and is associated with significant pain and disability. The aim of our review is to provide a practical approach for clinicians to inform assessment and management of patients with RP.Recent findingsAutoantibodies and nailfold capillaroscopy are key investigations to stratify the risk of progression to systemic sclerosis (SSc) in patients RP, which was recently confirmed in the multicenter, very early diagnosis of systemic sclerosis (VEDOSS) project. Research has explored the complex lived-patient experience of RP including digital vasculopathy in SSc and has highlighted the need for outcome measure development to facilitate research in the field. Pharmacological treatment strategies vary significantly internationally and there is continued interest in developing surgical approaches.SummaryWe provide a practical and up-to-date approach to inform the assessment and management of patients with RP including guidance on drug initiation and escalation. Calcium channel blockers are first-line treatment and can be initiated by primary care physicians. We also highlight second-line drug therapies used for refractory RP and the potential role for surgical intervention.

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Prazosin for Raynaud's phenomenon in progressive systemic sclerosis

Harding

Tingey

Pope

et al. 1998

Cochrane Database of Systematic Reviews

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A Double-blind Study of Prazosin in the Treatment of Raynaud's Phenomenon in Scleroderma

Cited by 41 publications

References 7 publications

Portuguese Recommendations for the management of Raynaud’s phenomenon and digital ulcers in systemic sclerosis and other connective tissue diseases

Portuguese Recommendations for the management of Raynaud’s phenomenon and digital ulcers in systemic sclerosis and other connective tissue diseases

Practical management of Raynaud's phenomenon – a primer for practicing physicians

Prazosin for Raynaud's phenomenon in progressive systemic sclerosis

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