Prostacyclin In The Treatment Of Raynaud’s Syndrome

Abstract

There is evidence to suggest that platelet activation occurs in Raynaud’s syndrome in the form of raised β-thromboglobulin and enhanced ADP induced aggregation. We evaluated the effect of prostacyclin (PGI2) in 5 female patients with Raynaud's syndrome. Out-patient visits were made at weekly intervals for 4 weeks. At the first visit buffer solution (Wellcome Laboratories) was infused intravenously for 5 hours, thereafter three five hour infusions of PGI2 at a peak dose of 10 ng/Kg/min were given. Six weeks after the infusions patients were reviewed. Symptomatic improvement including healing of ischaemic ulcers occurred in 4 out of 5 patients. Thermography of the hands confirmed an increase in hand temperature in 3 patients. No increase in temperature was observed in the one patient who did not improve symptomatically, nor in another patient who improved clinically but who had initially inflammation of the hand. Nausea and headache were experienced by all patients but only one patient required a decrease in PGI2 dose to 7.5 ng/Kg/min. We conclude that further evaluation of PGI2 in the treatment of Raynaud’s syndrome is warranted, especially as the duration of improvement far exceeded the duration of treatment.