Phosphodiesterase-5 inhibitors for the treatment of secondary Raynaud's phenomenon: systematic review and meta-analysis of randomised trials. Issue 10 (20th February 2013)

• Record Type: Journal Article
• Authors: Roustit, Matthieu; Blaise, Sophie; Allanore, Yannick; Carpentier, Patrick H; Caglayan, Evren; Cracowski, Jean-Luc
• Is Part Of: Annals of the rheumatic diseases. Volume 72:Issue 10(2013)
• Page Start: 1696
• Page End: 1699
• Publication Date: 2013-02-20
• Subjects: Systemic Sclerosis -- Cardiovascular Disease -- Outcomes research; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2012-202836
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Introduction: Recent controlled trials have assessed the efficacy of phospodiesterase-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.