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Many patients with secondary Raynaud phenomenon (RP) experience painful attacks and digital ulceration, despite aggressive vasodilator therapy. Sildenafil, a treatment for erectile dysfunction, has micro- and macrovascular dilatory effects and has been used to treat pulmonary hypertension.
In this double-blind trial, 18 patients with RP who were unresponsive to treatment with at least two conventional vasodilators were randomized to receive twice-daily sildenafil (50 mg) or placebo for 4 weeks. After a 1-week washout, subjects were switched to the other regimen for another 4 weeks. Symptoms were assessed using diary cards.
Among 16 subjects with secondary RP, sildenafil was associated with significantly fewer Raynaud attacks (mean, 35 vs. 52 …