From the Guidelines
Raynaud syndrome is a condition that should be managed by avoiding triggers, keeping extremities warm, and considering medications such as dihydropyridine-type calcium antagonists, like nifedipine, as first-line therapy for severe cases, as recommended by the most recent evidence 1.
Key Points
- The condition is characterized by episodes of reduced blood flow to the extremities, particularly the fingers and toes, in response to cold temperatures or stress.
- Affected areas typically turn white, then blue, and finally red as blood flow returns, often accompanied by pain, numbness, or tingling.
- Management includes:
- Avoiding triggers such as cold, trauma, stress, smoking, vibration injury, or certain drugs like bleomycin, clonidine, and ergot alkaloids 1.
- Keeping extremities warm by wearing proper clothing, such as a coat, mittens, hat, dry insulated footwear, and hand and/or foot warmers.
- Considering medications like dihydropyridine-type calcium antagonists, usually oral nifedipine, as first-line therapy for severe cases 1.
- Using phosphodiesterase type 5 (PDE-5) inhibitors, which have been shown to improve Raynaud’s condition score, reduce daily frequency and duration of RP attacks 1.
Treatment Approach
- Dihydropyridine-type calcium antagonists, like nifedipine, should be used as first-line therapy for SSc-RP 1.
- PDE5 inhibitors should also be considered for treatment of SSc-RP, given their high level of evidence supporting their use 1.
- Intravenous iloprost should be considered for severe SSc-RP following failure of oral therapy, although no new publications with higher level of evidence were identified 1.
From the Research
Overview of Raynaud Syndrome
Raynaud syndrome is a condition characterized by vasospasm of the digital arteries, resulting in transient, recurrent, and reversible constriction of peripheral blood vessels 2. It is a multifactorial vasospastic disorder that affects up to 5% of the general population 2.
Key Features
- Characterized by a triphasic discoloration of the affected area, beginning with pallor, followed by cyanosis, and finally ending with erythema 2
- Often associated with pain and can persist from several minutes to hours 2
- Can be idiopathic or a clinical manifestation of an underlying illness 2
- Triggers include emotional distress and low temperature 2