Nifedipine in the treatment of Raynaud's syndrome

Thirteen patients with Raynaud's syndrome (10 idiopathic and three with scleroderma) were treated with nifedipine or placebo in a double blind crossover study. The immediate response to 20 mg nifedipine or placebo and the response to a three week course of treatment (10 mg nifedipine eight hourly) were assessed by Doppler mapping of digital arteries, finger pulse volume recordings, skin temperature measurements, and arterial Doppler waveform analysis. In addition, the number, duration, and severity of vasospastic attacks were noted, together with patient and observer opinion of each treatment, an overall pain score, and patient preference. There was a significant reduction in the number of attacks and in linear analogue score for pain after three weeks of nifedipine. Patient and observer opinion showed a significant preference for nifedipine. The objective tests, however, failed to detect any significant change in either the short or long term. This study supports the use of nifedipine for the relief of symptoms in selected patients with Raynaud's syndrome and implies that it may have a unique mode of action.