Use of Continuous Infusion Epoprostenol in a Patient with Secondary Raynauds Phenomenon
Volume 2 ; Issue 1 ; in Month : Jan-Mar (2018) Article No : 124
Lemieux SM, Lopez F, Eng CC, et al.
Purpose: To describe a unique prostacyclin dosing regimen utilized to treat a case of secondary Raynaud�s phenomenon and summarize the existing literature on parenteral prostacyclin use for Raynaud�s phenomenon in adult patients. Summary: A 54-year-old female was admitted for initiation of continuous intravenous infusion epoprostenol to treat secondary Raynaud�s phenomenon which failed to respond to nifedipine and sildenafil. The infusion was titrated to a target dose of 9 ng/kg/min for 5 days. Upon completion of treatment, improvements in the patient�s pain, range of motion, and digital perfusion were observed. Sustained improvements were noted seven weeks later. Parenteral prostacyclins may therefore be considered for Raynaud�s phenomenon which fails to respond to conventional therapies. Epoprostenol has previously been used to treat Raynaud�s phenomenon mainly in the form of intermittent, intravenous infusions. There are logistical concerns associated with the use of a continuous infusion prostacyclin which should be addressed before this therapy is chosen. Conclusion: This case highlights a successful outcome in a patient with secondary Raynaud�s phenomenon treated with a 5-day continuous infusion of epoprostenol. It is reasonable to consider this treatment regimen in patients with secondary Raynaud�s phenomenon in whom other treatments have failed.
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