Topucal nitrates-A randomisd controlled study of 33
Patients found that topical glycerylrinirate applied to the
Dorsum of the finger resulted in digial vasodilatation with
Fewer systemic side effects than with oral nitrates.18Two
Large recent randomized conteolled trials of MQX-503, a
New formulation of niroglycerity, applied to the affected
Finger found that it reduces the severity of Raynaud’s phe-
Nomenon,but not the duration or frequency of attacy.19 20
Evidence on topical nitrates is limited, but the results of
Current trials may provide more robust evidence of efficacy.
Prostaglandins-Prostandins have vasodilatory and
Antiproliandins effects,and they inhibit platet aggrega-
Tion. Their side effects are similar to those of calcium chan-
Nel blockers. The European League Against Rheumatism
Recommends prostaglandins when calcium channel block-
Ers have failed.21 Most published studies have focused on
The use of intravenous iloprost. A randomised open label
Single centre study and a2009 Cochrane review found that
Iloprost reduces the frequency and severity of attacks.22 23
Terms of patient adherence and qualiy of life.24 However,
Two randomized controlled trials found that iloprost was