New lines in therapy of Raynaud's phenomenon.
Current knowledge about the pathogenesis of Raynaud's phenomenon (RP) results in novel approaches for therapy. Vasospasm without endothelial damage is thought to be the main cause for primary RP. The pathogenesis of secondary forms of RP is supposed to be initiated primary by endothelial damage. The aim of the review is to present main groups of medications as well as non-pharmacological regimen, that are used for the treatment of RP. The necessity of immediate assessment and treatment in severe forms of the disease with digital ulcers is highlighted. The mild forms of primary RP can be controlled by non-pharmacologic approaches. If the effect is insufficient, medications of first choice are calcium channel blockers. In the severe forms of the disorder, intravenous infusion of prostacyclin as well as endothelin-1 receptor antagonists and specific inhibitors of phosphodiesterase-5 are the treatment of choice. Treatment in the future may include selective blockers of alpha-2c adrenergic receptors, inhibitors of protein tyrosine kinase and Rho-kinase, as well as calcitonin gene-related peptide.
Lambova
Sevdalina Nikolova
SN
Clinic of Rheumatology, Medical University, Plovdiv, Bulgaria. sevdalina_n@abv.bg
Müller-Ladner
Ulf
U
D065130:Endothelin A Receptor Antagonists; D019332:Endothelin-1 / Q000627:therapeutic use*; D011464:Epoprostenol / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D011928:Raynaud Disease / Q000188:drug therapy*; D044022:Receptor, Endothelin A / Q000627:therapeutic use*; D016896:Treatment Outcome
D065130:Endothelin A Receptor Antagonists; D019332:Endothelin-1; D044022:Receptor, Endothelin A; D011464:Epoprostenol