期刊
CURRENT RHEUMATOLOGY REPORTS
卷 15, 期 1, 页码 -出版社
SPRINGER
DOI: 10.1007/s11926-012-0303-1
关键词
Raynaud's phenomenon; Systemic sclerosis; Digital ulcers; Digital ischemia; Critical ischemia; Clinical trials; Phosphodiesterase inhibitors; Endothelin-1 receptor antagonists; Glyceryl trinitrate; Prostanoids; Botulinum toxin; Nailfold capillaroscopy; Management
类别
资金
- Actelion Pharmaceuticals
- Pfizer
- MediQuest
- United Therapeutics Corp.
- Orion Pharma
This review focuses on new findings and developments relevant to the clinician caring for patients with primary and secondary [especially systemic sclerosis (SSc)-related] Raynaud phenomenon (RP). In the last 18 months, several clinical trials and observational studies of RP and of SSc-related digital ulceration have been published, reflecting increased awareness of disease burden and increased interest by pharmaceutical companies: new insights into pathophysiology are driving new approaches to treatment. Key developments are the increased use of phosphodiesterase type V inhibitors in severe RP, and of bosentan (an endothelin-1 receptor antagonist) for prevention of recurrent SSc-related digital ulcers. Other treatments being researched include topical glyceryl trinitrate (applied locally to the digits), botulinum toxin (for severe digital ischemia/ulceration), and several other drugs including oral prostanoids. Increased availability and interest in nailfold capillaroscopy, by facilitating early diagnosis of SSc, should pave the way for studies of early intervention and vascular protection.
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