Phosphodiesterase-5 inhibitors may ease symptoms of Raynaud’s syndrome

Recently presented data showed patients with Raynaud’s syndrome treated with phosphodiesterase-5 inhibitors had reduced frequency and duration of disease flares, which were also less painful following treatment.

Using the Cochrane Library, MEDLINE, EMBASE and ClinicalTrials.gov to identify randomized controlled trials, researchers examined data from 255 patients with Raynaud’s syndrome treated with either phosphodiesterase-5 inhibitors or placebo. Of these patients, 97% had the disease secondary to systemic sclerosis. The studies included four trials with tadalafil, two trials with sildenafil and one trial with vardenafil. Characteristics identified included frequency, duration and severity of attacks and pain, Patient Global Scale score, withdrawals and serious adverse events, which investigators analyzed with fixed effects models, standardized mean differences or pooled risk ratios.

Analysis showed the frequency of attacks was reduced by 4.2 attacks per week in patients treated with phosphodiesterase-5 inhibitors from a baseline of 26 attacks per week, a 22% reduction in the relative frequency of attacks. The attack duration was reduced by 6 minutes, a relative reduction of 24%.

In the one trial that assessed severity of attacks, the Raynaud’s Condition Score improved by 0.49 cm and VAS pain improved by 1.06 points, with a 25% decrease in pain reported. A relative reduction of 39% was observed for disability. The sample size was not large enough to identify differences between the three phosphodiesterase-5 inhibitors studied, according to the researchers. - by Shirley Pulawski

Reference:

Pope JE, et al. Paper #2977. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.

Disclosures: The researchers report no relevant financial disclosures.