Treatment of Raynaud’s phenomenon: New insights and developments

Herrick, Ariane L.

doi:10.1007/s11926-003-0046-0

Cited by 32 publications

(12 citation statements)

References 43 publications

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“…19,20 Livedo reticularis is a common feature of SLE that does not warrant treatment but is associated with dysautonomia and the presence of antiphospholipid antibodies. Usually independent of inflammatory activity, Raynaud's phenomenon represents vasomotor instability as a manifestation of dysautonomia.…”

Section: Cutaneovascular Manifestations: Raynaud's Phenomenon Livedomentioning

confidence: 99%

Management of Nonrenal Systemic Lupus Erythematosus 2

Wallace¹

2010

Targeted Treatment of the Rheumatic Diseases

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Section: Cutaneovascular Manifestations: Raynaud's Phenomenon Livedomentioning

confidence: 99%

Management of Nonrenal Systemic Lupus Erythematosus 2

Wallace¹

2010

Targeted Treatment of the Rheumatic Diseases

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“…19 However, the time frame for the rise in von Willebrand factor, fibrinogen, and 3-nitrotyrosine after digital cold provocation remains to be established, though it has been suggested that levels of these peptides rise in a similar pattern to that of endothelin-1. 20 21 We therefore studied changes in both pulmonary haemodynamics and endothelial function in a cohort of patients with systemic sclerosis suspected of having PAH, using cold pressor challenges given both peripherally and centrally.…”

Section: And Kozielski Et Almentioning

confidence: 99%

The myth of pulmonary Raynaud's phenomenon: the contribution of pulmonary arterial vasospasm in patients with systemic sclerosis related pulmonary arterial hypertension

Mukerjee

2004

Annals of the Rheumatic Diseases

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Objective: To investigate the contribution of cold induced pulmonary vasospasm by peripheral and central cold stimulus in exacerbating pulmonary arterial hypertension (PAH) in patients with systemic sclerosis undergoing cardiac catheterisation. Methods: In a prospective pilot study, 21 patients with systemic sclerosis and catheter proven PAH had mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac output (CO) measured before and after peripheral (hand immersion into cold water at 10-15˚C for two minutes if tolerated) and central (direct cold water at 4˚C injected into the right atrium) cold pressor challenge. Markers of endothelial activation, platelet function, and nitric oxide degradation were measured in blood sampled from the pulmonary artery. Results: 19 of the patients (mean (SD) age, 56 (4) years; baseline mPAP, 34 (8) mm Hg; PVR, 420 (87) dyne.s.cm 25 ; CO, 6.4 (1.8) l/min) tolerated cold hand immersion for the maximum two minute duration. All 21 tolerated central cold pressor challenge (three to five injections of 10 ml saline boluses at 4˚C). There was no significant change in haemodynamics after cold challenge by either route of provocation. Levels of endothelin-1, von Willebrand factor, fibrinogen, and 3-nitrotyrosine were raised compared with control values in patients with systemic sclerosis but without PAH, but did not change significantly after peripheral cold challenge. Conclusions: Pulmonary vasospasm in response to peripheral and centrally administered cold pressor challenge is unlikely to contribute to persistence of pulmonary arterial hypertension in patients with systemic sclerosis.

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“…The treatment is mostly dependent on the etiology of the disorder and on the presence and severity of the individual symptoms. Lifestyle modifications including avoidance of cold exposure and caffeine, discontinuation of smoking, and sufficient body insulation, are the first line of treatment for the prevention of vasospasm [11, 12]. If these modifications are insufficient, calcium channel blockers are the most widely used pharmacological agents for treatment [4, 13, 14], and in severe forms of RP, prostaglandins, endothelin-1 receptor antagonists, and specific inhibitors of phosphodiesterase-5 are the treatments of choice [6].…”

Section: Introductionmentioning

confidence: 99%

Acupuncture in subjects with cold hands sensation: study protocol for a randomized controlled trial

Jung-Chul¹,

Lee

Kwak

et al. 2014

Trials

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BackgroundCold hands sensation is a common disorder within the Korean population. Many Korean family physicians believe that it is a mild early manifestation of Raynaud’s phenomenon (RP), or may be related to RP. RP is characterized by reversible digital vasospasm provoked by cold temperatures and/or emotional stress, and doctors often prescribe medications that are used in treatment of RP for subjects with cold hands. However, this has not shown a clear benefit, and these medications can cause unwanted side effects. It is also reported that traditional Korean medicine, including acupuncture, is widely used to treat cold hands, although the current level of evidence for this approach is also poor and to date, there have been no published randomized controlled clinical trials (RCTs) evaluating the efficacy and safety of acupuncture for cold hands. We have therefore designed a pilot RCT to obtain information for the design of a further full-scale trial.Methods/DesignThe proposed study is a five-week pilot RCT. A total of 14 subjects will be recruited and randomly allocated to two groups: an acupuncture plus medication group (experimental group) and a medication-only group (control group). All subjects will take nifedipine (5 mg once daily) and beraprost (20 mg three times daily) for three weeks. The experimental group will receive additional treatment with three acupuncture sessions per week for three weeks (nine sessions total). The primary outcome will be measured using a visual analogue scale. Secondary outcomes will be measured by blood perfusion in laser Doppler perfusion imaging of the hands, frequency and duration of episodes of cold hands, and heart rate variability. Assessments will be made at baseline and at one, three, and five weeks thereafter.DiscussionThis study will provide an indication of the feasibility and a clinical foundation for a future large-scale trial.Trial registrationThis study was registered at Korean Clinical Research Information Service (CRIS) registry on 5 August 2013 with the registration number #KCT0000817.

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Treatment of Raynaud’s phenomenon: New insights and developments

Cited by 32 publications

References 43 publications

Management of Nonrenal Systemic Lupus Erythematosus 2

Management of Nonrenal Systemic Lupus Erythematosus 2

The myth of pulmonary Raynaud's phenomenon: the contribution of pulmonary arterial vasospasm in patients with systemic sclerosis related pulmonary arterial hypertension

Acupuncture in subjects with cold hands sensation: study protocol for a randomized controlled trial

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