Nifedipine in primary Raynaud's phenomenon and in scleroderma: oral versus sublingual hemodynamic effects.
In 16 patients with Raynaud's phenomenon a placebo-controlled single-dose study was performed on the hemodynamic effects of 10 mg nifedipine, sublingually administered, followed by an open eight-week study on the therapeutic efficacy of chronic oral nifedipine, 10 mg qid. After the acute sublingual nifedipine administration, a pronounced objective improvement of finger skin (P = .013) and forearm muscle blood flow (P = .04) during a standard finger-cooling test was found. During the chronic oral study the improvement in objective efficacy parameters disappeared, except for laser Doppler estimated shunt flow (P = .07). The acute hemodynamic effects did not predict the long-term results in individual patients. Patients with systemic sclerosis reacted as well as patients with primary Raynaud's phenomenon. This study shows that orally administered nifedipine does not convey long-term objective benefit to patients with Raynaud's phenomenon. The apparent increase in vasodilation during acute administration suggests that sublingual nifedipine prophylactically or during a vasospastic attack may be more useful.
Department of Medicine, St. Radboud University Hospital, Nijmegen, The Netherlands.
H
H
Wollersheim
T
T
Thien
A
A
van 't Laar
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage / Q000627:therapeutic use*; D011928:Raynaud Disease / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D012595:Scleroderma, Systemic / Q000150:complications / Q000188:drug therapy*
D009543:Nifedipine