Phosphodiesterase-5 inhibitors for the treatment of Raynaud's: a novel indication

Abstract

Background: Raynaud's phenomenon is a common clinical condition characterized by significant morbidity, especially in patients who have an underlying connective tissue disorder. These patients suffer from a worse clinical phenotype that at times can lead to digital vessel occlusion. Current therapies are not optimal, and better therapeutic options are needed. Objective: To describe the up-to-date data available on the use of phosphodiesterase 5 inhibitors in the treatment of Raynaud's phenomenon. Methods: We performed a literature search of PubMed from 1990 – 2008, as well as a search of the abstracts presented at the American College of Rheumatology scientific meeting and the European League Against Rheumatism scientific meeting for the years 2001 – 2007. The search terms used were ‘Raynaud's’, ‘phosphodiesterase 5 inhibitors’, ‘ tadalafil’, ‘sildenafil’ and ‘vardenafil’. Results/conclusion: Based on current data from small clinical trials, open-label pilot studies and case series and reports, phosphodiesterase 5 inhibitors may help some patients with very serious Raynaud's. A large, well-conducted multicenter, double-blind study is needed to determine the benefit and risk of these agents in Raynaud's phenomenon.

Keywords::

• phosphodiesterase-5 inhibitors
• Raynaud's
• sildenafil
• treatment
• tadalafil
• vardenafil