[Treatment of severe Raynaud syndrome in scleroderma or thromboangiitis obliterans with prostacyclin (prostaglandin I2)].
Eleven patients with severe Raynaud's syndrome were treated with intravenous infusion of prostacyclin (Prostaglandin I2). Raynaud's syndrome was caused by inflammatory diseases such as progressive systemic sclerosis (N = 9) or thromboangiitis obliterans (N = 2). Five patients had acral ulcerations. Treatment with prostacyclin lead to immediate cessation of acral pain in all patients if doses of 5-6 ng/kg/min were tolerated. In 7 out of 11 patients there was a long-term analgesic effect with clinical improvement of Raynaud's syndrome. In three of five patients we achieved healing of the ulcerations within a few weeks. Plasmaconcentrations of prostaglandin F1-alpha, the main metabolite of prostacyclin, were about 10 times above normal during infusion and returned to normal levels within 30 min after the end of the infusion, in spite of the prolonged clinical effect. Therefore, prostacyclin alone cannot be responsible for the long-term clinical benefit. (Parts of this publication were published as an abstract and presented at the 23rd Congress of the Deutsche Gesellschaft für Rheumatologie (15).
Rüthlein
H J
HJ
Medizinische Universitätsklinik Würzburg.
Riegger
G
G
Auer
I O
IO
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D011464:Epoprostenol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006225:Hand / Q000098:blood supply; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011928:Raynaud Disease / Q000628:therapy*; D012039:Regional Blood Flow / Q000187:drug effects; D012595:Scleroderma, Systemic / Q000628:therapy*; D013919:Thromboangiitis Obliterans / Q000628:therapy*
D011464:Epoprostenol
Behandlung des schweren Raynaud-Syndroms bei Sklerodermie oder Thromboangiitis obliterans mit Prostacyclin (Prostaglandin I2).