Viagra Effective Against Severe Raynaud's Phenomenon

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Viagra Effective Against Severe Raynaud's Phenomenon

By Jeff Minerd , MedPage Today Staff Writer

Reviewed by Rubeen K. Israni, M.D., Fellow, Renal-Electrolyte and

Hypertension Division, University of Pennsylvania School of Medicine

Source News Article: ABC News, Forbes, MSNBC

MedPage Today Action Points

This small study provides initial evidence that Viagra may be helpful

in treating patients with secondary Raynaud's phenomenon that is

resistant to vasodilator therapy.

Viagra is not FDA approved for the treatment of Raynaud's phenomenon.

Review

HOMBURG, Germany, Nov. 8 - Viagra (sildenafil) has shown efficacy for

refractory Raynaud's phenomenon, researchers reported here.

The drug significantly reduced the frequency and duration of Raynaud

attacks and improved capillary flow velocity by 400%, according to a

study led by Roland Fries, M.D., of the University of Saarland here

and published online in the Circulation, Journal of the American

Heart Association.

The randomized crossover study evaluated the effectiveness of

sildenafil in 16 patients with secondary Raynaud's phenomenon

resistant to vasodilator therapy.

Patients were treated with 50 mg of Viagra or placebo twice daily for

four weeks. Symptoms were assessed by diary cards, which included a

10-point Raynaud's Condition Score. Capillary flow velocity was

measured in digital capillaries with a laser Doppler anemometer.

While taking sildenafil, the mean frequency of Raynaud attacks was

significantly lower (35±14 attacks during the four weeks versus 52

±18; P=0.0064), the cumulative attack duration was significantly

shorter (581±133 minutes versus 1046±245 minutes; P=0.0038), and the

mean Raynaud's Condition Score was significantly lower (2.2±0.4

versus 3.0±0.5; P=0.0386).

Capillary blood flow velocity increased in each individual patient,

and the mean capillary flow velocity of all patients more than

quadrupled after treatment with sildenafil (0.53±0.09 versus 0.13

±0.02 mm/s, P=0.0004).

In all six patients with chronic digital ulcerations, the lesions

began to visibly heal during treatment with Viagra, the researchers

added.

Two patients reported side effects leading to discontinuation of the

study drug: one from headache and one from muscle pain in the legs.

No patients reported side effects during placebo, most likely because

all patients correctly identified when they were on treatment or

placebo, the study authors said.

" Overall, our results demonstrate for the first time in a randomized

study the efficacy of treatment with sildenafil on microcirculation

and symptoms in patients with therapy-resistant Raynaud's

phenomenon, " they concluded.

Primary Raynaud's phenomenon is characterized by temperature-

sensitive vasospasms leading to pale and cyanotic skin in the fingers

and toes, with accompanying numbness, tingling, or pain. The

secondary form, occurring in connective tissue disease, presents more

severely with ulceration or tissue necrosis.

Current treatments include vasodilators such as calcium channel

blockers and angiotensin II receptor agonists, but they don't work

for all patients, the researchers said.

" Overall, our results demonstrate for the first time in a randomized

study the efficacy of treatment with sildenafil on microcirculation

and symptoms in patients with therapy-resistant Raynaud's

phenomenon, " they concluded.

Primary source: Circulation

Source reference:

Fries R et al. Sildenafil in the treatment of Raynaud's phenomenon

resistant to vasodilatory therapy. Circulation. Advanced online

publication November 8, 2005.