What is the role of alpha-adrenergic antagonists in the treatment of CREST syndrome?

Updated: Oct 05, 2020
  • Author: Jeanie C Yoon, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Alpha-adrenergic antagonists have received some interest recently as a new treatment for Raynaud phenomenon. An experimental selective alpha(2C)-adrenergic receptor blocker was well tolerated and improved digital skin perfusion during recovery from cooling in patients with Raynaud phenomenon associated with scleroderma. [108] One case report describes a patient who paradoxically experienced worsening of Raynaud phenomenon while using the alpha-2 adrenergic antagonist yohimbine. [109] Further research is needed before the efficacy and safety of this class of drugs can be established for use in this disease.

Bosentan, an orally active competitive endothelin-1 antagonist that blocks the endothelin receptors, is being used for systemic sclerosis-associated pulmonary arterial hypertension, and this agent may also help alleviate vasospasm and prevent digital ulceration; however, clinical trials need to be performed first. [110]


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