beraprost and Raynaud-Disease

We investigated the effect of beraprost sodium (BPS) on the Raynaud's phenomenon on 15 patients with systemic sclerosis, 3 with mixed connective tissue disease and 1 with Raynaud's disease, respectively. After 12 weeks of administration of 60 micrograms/d BPS, the duration and the incidence of the Raynaud's symptom were significantly reduced and the dermal temperature on the fingers was found to be elevated. Of the parameters which are known to reflect vascular endothelial damages such as tissue plasminogen activator (t-PA), von Willebrand's factor (vWF) and endothelin, the plasma level of t-PA was significantly reduced by BPS. Furthermore, the capillary loop in the nail bed of the fingers seemed to increase in one patient by the treatment with BPS. These results suggest that BPS has a capacity to repair peripheral vascular damages resulting in the improvement of Raynaud's phenomenon.

Topics: Adult; Aged; Biomarkers; Endothelins; Epoprostenol; Female; Fingers; Humans; Male; Middle Aged; Raynaud Disease; Skin Temperature; Tissue Plasminogen Activator; Vasodilator Agents; von Willebrand Factor

To compare the efficacy and tolerance of beraprost sodium, an oral prostanoid prostaglandin I2 analog, with a placebo in patients with primary Raynaud's phenomenon (RP).. 125 patients with disabling primary RP participated in a multicenter, randomized, double blind trial in 2 parallel groups, lasting 8 weeks, and conducted during the winter months only; a meteorological survey was also conducted for each patient. Main outcome measures were frequency and severity of attacks of RP, overall disability, and digital cold challenge tests.. The number of attacks decreased significantly in both groups (confidence intervals of improvement: 35-53% in beraprost group and 25-49% in placebo group), but did not differ significantly in the 2 groups. Similar results were found for the severity of RP attacks and overall disability. No severe side effects occurred, but headache was more frequent in the beraprost group (p = 0.001). Cold tests remained equally abnormal in both groups throughout the study.. Although we observed 37% improvement in the number of attacks of RP in the beraprost group, prostanoid treatment proved no more beneficial than placebo.

Topics: Administration, Oral; Adult; Cold Temperature; Double-Blind Method; Epoprostenol; Female; Fingers; Hemodynamics; Humans; Male; Middle Aged; Raynaud Disease; Treatment Outcome; Vasodilator Agents

Raynaud's phenomenon is an important clinical manifestation in patients with systemic sclerosis (SSc). No effective therapy, however, has been established for this phenomenon. Beraprost sodium, a stable prostacycline (PGI2) analogue, has been reported to improve hemorrheological impairment in patients with rheumatic diseases. In this study, we, therefore, examined the efficacy of beraprost sodium on Raynaud's phenomenon in 30 patients with SSc. Sixty micrograms per day of beraprost sodium was found to be effective in 14 patients (47%) in the period of 15.0 +/- 12.5 weeks. Raynaud's phenomenon in patients who responded to beraprost sodium was characterized by infrequent nail fold thrombosis and narrower hand areas affected by Raynaud's phenomenon, with mild secondary symptoms such as pain. These results indicate that beraprost sodium is effective for mild forms of Raynaud's phenomenon in patients with SSc.

Topics: Adult; Epoprostenol; Female; Humans; Male; Middle Aged; Platelet Aggregation Inhibitors; Raynaud Disease; Scleroderma, Systemic; Vasodilator Agents