Current treatment options in Raynaud’s phenomenon

Abstract

The treatment of Raynaud's phenomenon (RP) strictly depends on the severity of symptoms and on the presence of an underlying systemic disease. For this reason, any patient with RP should be carefully assessed for signs and symptoms that may herald an underlying disease. Primary RP can usually be managed with conservative nonpharmacologic lifestyle modifications (eg, avoidance of cold temperatures, tobacco, caffeine, and any drug interfering with vascular tone) and pharmacologic treatment added only if attacks are poorly controlled. Vasodilating drugs (eg, calcium channel blockers, angiotensin II receptor antagonists, topical nitrates, and prostanoids) are still the mainstay of medical therapy for RP. Anecdotal reports with different kinds of therapies appear regularly but always need evidence-based confirmation. In particular, antioxidant agents may be useful in limiting the progressive endothelial damage. Novel therapeutic tools interfering either with primary or secondary pathogenetic processes (ie, endothelial and peripheral nervous system dysfunction and smooth muscle cell hypertrophy) are awaited.

A Rare Pathology For Sudden Death İn a Raynaud Phenomenon: Resistant Coronary Vasospazm

“…Raynaud phenomenon involves especially upper extremite digital arteries but the presence of microvascular circulation disorder in the coronary arteries may cause vasospazm and angina pectoris. Raynaud phenomenon may affect visceral organs; esophageal spasm may be seen, pulmonary hypertension may develop because of pulmonary vascular bed involvement, coronary vasospasm when coronary artery involvement and migraine when cerebral vessels affected (1). The presence of dyspnea in patients with Raynaud phenomenon may be a sign of pulmonary hypertension or coronary vasospasm (2).…”

No Significant Effect of Ginkgo Biloba Special Extract EGb 761 in the Treatment of Primary Raynaud Phenomenon

“…Lifestyle modification, such as avoidance of cold exposure and caffeine, discontinuation of smoking, and sufficient body insulation, is the first option for the prevention of vasospastic attacks in RD. 6,7 So far, medicinal treatment of RD is limited to primarily vasodilator medicines. In particular, calcium channel antagonists such as nifedipine have been proven useful.…”