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Rheumatology • Continue the Conversation
Do you recommend vasodilators in patients with Raynaud's who have capillary drop out but are otherwise not bothered enough by their symptoms to want to pursue systemic treatment?
This question is part of our collaboration with ACR Convergence 2025 to Continue the Conversation from the meeting. This question was inspired by the session "Challenges & Solutions for Management of Raynaud’s Phenomenon" by Dr. @Tracy M. Frech and Dr. @John Pauling. If you did not attend the meeting, information about Convergence On Demand can be found here.
Answer from: at Community Practice
If patients find their RP symptoms manageable, then I do not usually start vasodilators purely on account of the level of capillary drop out. The principle aim of treatment is to help with symptoms, and we do not yet have a strong enough evidence base to justify such treatments for disease modificat...
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Answer from: at Academic Institution
Vasodilator therapy for Raynaud’s phenomenon (RP) is primarily aimed at reducing the frequency and duration of vasospastic attacks, thereby improving symptoms. For this reason, nailfold capillary abnormalities in the absence of significant RP symptoms do not currently justify initiating treatm...
Answer from: at Academic Institution
I typically do not unless they have had ischemic events in the past (like pitting or ulcers). Unfortunately, we do not have good longitudinal data to support the idea that prophylactically treating patients with vasodilators when they are otherwise minimally symptomatic will have a preventative role...