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Prazosin for Raynaud's phenomenon in progressive systemic sclerosis
1Medicine (Division of Rheumatology), University of Western Ontario, LHSC-South Campus, 375 South Street Room 309;Colborne Bldg., London, Ontario, Canada, N6A 4G5. jpope@julian.uwo.ca
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Prazosin offers modest benefits for scleroderma-related Raynaud's phenomenon (RP), but side effects are common. This review evaluated prazosin versus placebo for RP treatment in scleroderma patients.
Area of Science:
- Rheumatology
- Pharmacology
- Clinical Trials
Background:
- Scleroderma is an autoimmune disease that can cause Raynaud's phenomenon (RP), a condition characterized by vasospasm in the extremities.
- RP in scleroderma patients can lead to significant morbidity and impact quality of life.
Purpose of the Study:
- To evaluate the efficacy and toxicity of prazosin compared to placebo for treating Raynaud's phenomenon secondary to scleroderma.
- To synthesize evidence from randomized controlled trials on prazosin for scleroderma-associated RP.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched major databases including Cochrane Controlled Trials Register and Medline up to April 1997.
- Included RCTs comparing prazosin to placebo in scleroderma patients with RP, excluding trials with high dropout rates (>35%).
Main Results:
- Two RCTs with a total of 40 patients met the inclusion criteria.
- Prazosin demonstrated a modest but statistically significant improvement in clinical outcomes compared to placebo for RP in scleroderma.
- Adverse events were reported with prazosin, indicating a notable side effect profile.
Conclusions:
- Prazosin provides a modest therapeutic benefit for Raynaud's phenomenon in the context of scleroderma.
- The observed benefits must be weighed against the potential for side effects when considering prazosin treatment.