trials currently testing rho kinase inhibitors as a method of
Vasodilation
MQX-503 (nitroglycerin) shows potential in reducing the
Severity of Raynaud’s phenomenon
Preliminary repduces the frequency of attacks, and improves the
Healing of digtal ulcers
Oral phosphodiesterase type 5 inhibitors may be affectvie in
Patients with severe and disabling Raynaud’s phenomenon,
although further studies are needed
Only slighty better than nifedipine,25 and because ilo-
Prost is more expensive, the European League Against
Rheumatism has advised that nifedipine should remain the
First line drug for patients with Raynaud’s phenomenon.
A double blind multicenter placebo controlled study and
Randomized double blind study found that orally admin-
Istered prostaglandins are less effective than intravenons
Ones,although higher doser may confer benefit.21 Research
Is currently ongoing into the use of treprostinil, an oral
Prostaglandin analogue,
Phosphodiesterase type 5 inhibitors (sildenafil, tadata-
Fil, and vardenafil)-Phosphodiesterase type 5 breaks
Down cGMP in endothelial cells. Inhibition of this enzyme
Increases the amount of cGMP available to promote vascu-
Lar smooth muscle relaxation and blood flow. A randmised
Double blind placebo controlled fixed dose crossover study
And two case series found a decrease in the frequency and
Severity of attacks in patients treated with oral sildenafil but
Not tadalafil compared with placebo. These inhibitors also
Have a favourable effect on the Raynaud’s condition score
And ulcer healing,26 28 The benefits of these orally delivered
And well tolerated drugs suggest that they may be an effect-
Tive treatment for patients with severe and disabling Ray-
Naud’s phenomenon, although further studies are needed.