title: Phosphodiesterase-5 inhibitors for the treatment of secondary Raynaud's phenomenon: systematic review and meta-analysis of randomised trials.
abstract: BACKGROUND
  Recent controlled trials have assessed the efficacy of phosphodiesterase-5 (PDE-5) inhibitors in secondary Raynaud's phenomenon (RP). However, the conclusions are conflicting, and whether these drugs are effective remains unclear. The objective of this meta-analysis was to determine the efficacy of PDE-5 inhibitors on Raynaud's Condition Score (RCS) and frequency and duration of attacks.
  
  
  METHODS
  A systematic review of articles was performed (sources included Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials). Only double-blind, randomised controlled trials (RCTs) were included. Studies were selected independently by two authors using predefined data fields, including study quality indicators.
  
  
  RESULTS
  Six RCTs were included (one with sildenafil, one with modified-release sildenafil, three with tadalafil and one with vardenafil). PDE-5 inhibitors significantly decreased mean RCS by -0.46 (-0.74 to -0.17) (p=0.002), the daily frequency of ischaemic attacks by -0.49 (-0.71 to -0.28) (p<0.0001), and daily duration of RP attacks by -14.62 (-20.25 to -9.00) min (p<0.0001).
  
  
  CONCLUSIONS
  PDE-5 inhibitors appear to have significant but moderate efficacy in secondary RP. A further large RCT is needed.
authors: Inserm U1042, Université Joseph Fourier, Grenoble, France. MRoustit@chu-grenoble.fr
authors: Matthieu
authors: M
authors: Roustit
authors: Sophie
authors: S
authors: Blaise
authors: Yannick
authors: Y
authors: Allanore
authors: Patrick H
authors: PH
authors: Carpentier
authors: Evren
authors: E
authors: Caglayan
authors: Jean-Luc
authors: JL
authors: Cracowski
mesh_terms: D002243:Carbolines / Q000627:therapeutic use; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use; D011687:Purines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D011928:Raynaud Disease / Q000188:drug therapy*; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use; D000068581:Tadalafil; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use; D000069058:Vardenafil Dihydrochloride
chemical_list: D002243:Carbolines; D007093:Imidazoles; D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride; D000068581:Tadalafil; D000068677:Sildenafil Citrate
keywords: Cardiovascular Disease; Outcomes research; Systemic Sclerosis