Phosphodiesterase Inhibitors in Raynaud's Phenomenon

Abstract

Available evidence suggests that sildenafil may be associated with improved microcirculation, symptomatic relief, and ulcer healing in patients with secondary Raynaud's phenomenon. Limited information suggests similar effects with tadalafil and vardenafil. Improved blood flow and clinical improvements have also been observed in some patients with primary Raynaud's phenomenon treated with PDE5 inhibitors; however, studies have yielded conflicting results.

cGMP-Dependent Protein Kinases and cGMP Phosphodiesterases in Nitric Oxide and cGMP Action

“…Sildenafil (marketed as Revatio) and tadalafil (marketed as Adcirca) are also approved for treatment of pulmonary hypertension Falk et al, 2010). PDE5 inhibitors have also been shown to be effective in treatment of Raynaud's disease, although they are currently not approved for this use (Fries et al, 2005;Levien, 2006).…”

Molecular Pharmacotherapeutic Targeting of PDE5 for Preservation of Penile Health

“…As the best example, PDE5 inhibitors have gained regulatory agency approval for treating pulmonary hypertension (Barnett and Machado, 2006). Their therapeutic role has also been investigated for other cardiovascular disease states, including Raynaud syndrome, type 2 diabetes, and chronic heart failure (Desouza et al, 2002; Patel and Katz, 2005; Levien, 2006). PDE5 inhibitors have also been shown to exert immune‐mediated antitumor effects, indicating alternative pharmacologic strategies for these drugs (Serafini et al, 2006).…”

Raynaud’s phenomenon and digital ischemia: a practical approach to risk stratification, diagnosis and management

“…Through this mechanism PDE-I’s cause vasodilation and increase perfusion to distal tissues [77]. This class of drugs has demonstrated significant effects in patients with digital ischemia [78–81]. The five drugs available in this class of medications include sildenafil, tadalafil, vardenafil, pentoxifylline, and cilostazol, and the first two listed are better studied.…”