In a randomized, placebo-controlled, crossover study, 15 ambulatory pa tients with Raynaud's phenomenon, treated for three weeks with ketanserin 80 mg/day and pentoxiphylline 1,200 mg/day, were evaluated by subjective symp tom scores, daily frequency and duration of attacks, and photoplethysmog raphy, at room temperature and after cold test. Reduced subjective symptoms and duration of attacks, together with improved cold test plethysmography, were significant only after ketanserin. All subjective symptom scores also im proved after ketanserin but only for cyanosis and paresthesia after pentoxiphyl line. Excellent results were obtained in 4 cases after ketanserin and in 1 case with pentoxiphylline. The authors discuss the greater importance of antivaso spastic action over antiaggregating and hemorheologic effects in Raynaud's phenomenon therapy, as well as the pathogenetic role of serotonin.
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References
1.
Kallenberg Cgm , Wouda AA, The TH: Systemic autoimmune disease and Raynaud's phenomenon: A common immunologically mediated, vascular basis? A hypothesis . Neth J Med27:322-326, 1984.
2.
Rodnan GP, Myerowitz RL, Justh GO: Morphologic changes in digital arteries of patients with progressive systemic sclerosis and Raynaud's phenomenon. Medicine59:393-408, 1980.
Wesseling H. : Drug treatment in Raynaud's phenomenon. Vasa (Suppl 18):48-53, 1987.
7.
Jageneau Ahm , Horig C., Loots W., et al: Plethysmographic registration of volume changes in a hand vein. Effect of serotonin and of a specific antagonist. Angiology31:828-832, 1980.
8.
DeClerk F., David JL, Janssen Paj: Inhibition of 5-HTP-induced and amplified human platelet aggregation by ketanserin (R41468) a selective 5HT2-antagonist. Agents Actions12:388-397, 1982.
9.
Angelkort B. , Spurk P., Habbaba A., et al: Blood flow properties and walking performance in chronic arterial occlusive disease. Angiology36:285-292, 1985.
10.
Ward A., Clissold SP: Pentoxifylline. A review of its pharmacodynamic and pharmacokinetic properties and its therapeutic efficacy. Drugs34:50-97, 1987.
11.
Moncada S., Vane JR: Prostacyclin in the cardiovascular system. Adv Prostaglandin Thromboxane Res6:43-60, 1980.
12.
Halpern A., Kuhn PH, Shaftel HE, et al: Raynaud's disease, Raynaud's phenomenon and serotonin. Angiology11:151-167, 1960.
13.
Hutton RA, Mikhadidis DP, Bernstein RM, et al: Assessment of platelet function in patients with Raynaud's syndrome . J Clin Pathol37:182-187, 1984.
14.
Malamet R., Wise RA, Ettinger WH, et al: Nifedipine in the treatment of Raynaud's phenomenon. Evidence for inhibition of platelet activation. Am J Med78:602-608, 1985.
15.
Seibold JR, Harrys JN: Plasma beta-thromboglobulin in the differential diagnosis of Raynaud's phenomenon . J Rheumatol12:99-103, 1985.
16.
Neirotti M. , Longo F., Molaschi M., et al: Functional vascular disorders: treatment with pentoxifylline. Angiology38:575-580, 1987.
17.
van derMeer J., Wouda AA, Kallenberg Cgm, et al: A double-blind controlled trial of low-dose acetylsalicylic acid and dipyridamole in the treatment of Raynaud's phenomenon. Vasa (Suppl 18):71-75, 1987.
18.
Stranden E. , Roald OK, Krohg K.: Treatment of Raynaud's phenomenon with 5HT2-receptor antagonist: Ketanserin. Br Med J285:1069-1071, 1982.
19.
Roald OK, Seem E.: Treatment of Raynaud's phenomenon with ketanserin in patients with connective tissue disorders. Br Med J289:577-579, 1984.
20.
Brouwer Rml , Wenting GJ, Visser W., et al: Does serotonin receptor blockade have a therapeutic effect in Raynaud's phenomenon? Vasa (Suppl 18):64-67, 1987.
21.
van de Wal Hjcm, Wijn Pff, van Lier Hjj, et al: The effectiveness of ketanserin in patients with primary Raynaud's phenomenon. Int Angiology6:312-322, 1987.
22.
Meloni F., Transi MG, Sciacca V., et al: Therapeutic efficacy of ketanserin, a selective antagonist of the serotonin (5-HT2) receptors in primary and secondary Raynaud's phenomenon . Angiology38:530-536, 1987.
23.
Seibold JR, Jageneau Ahm: Treatment of Raynaud's phenomenon with ketanserin, a selective antagonist of serotonin 2 (5-HT2) receptors. Arthritis Rheum27:139-146, 1984.
24.
Jacobs Mjhm , Slaaf DW, Lemmens Haj, et al: The use of hemorheological and microcirculatory parameters in evaluating the effect of treatment in Raynaud's phenomenon. Vasc Surg21:9-16, 1987.
25.
Tindall H., Tooke JE, Menys VC, et al: Effect of dazoxiben, a thromboxane synthetase inhibitor, on skin blood flow following cold challenge in patients with Raynaud's phenomenon . Eur J Clin Invest15:20-23, 1985.
