A by Charles Khouri and colleagues examined the extent drugs are capable of inducing Raynaud's phenomenon (RP).
The authors found 12 different classes of drugs responsible for RP, with cisplatin and bleomycin having the greatest risk, followed by beta-blockers. The Framingham Heart Study found beta-blocker use was the most common cause of secondary RP (34.2% of secondary RP). A 2012 meta-analysis found a prevalence of 14.7% of RP in patients receiving beta-blockers.
Other less frequently cited causes include clonidine, ergot alkaloids, bromocriptine, ADHD drugs (methylphenidate and dextroamphetamine), phentermine (for weight loss), cocaine, vinyl chloride exposure, and interferon therapy. Potential mechanisms include a variety of underlying mechanisms such as increased sympathetic activation, endothelial dysfunction, neurotoxicity, or decreased red blood cell deformability. Tyrosine kinase inhibitors have also been reported to cause RP, although the mechanism is unknown.
Drug-induced RP is probably underestimated. Although most reports are benign, there are few rare, serious complications such as digital ischemia and ulceration reported.
, is the director of clinical rheumatology at the Baylor Research Institute and a professor of medicine and rheumatology at Baylor University Medical Center in Dallas. He is the executive editor of . A version of this article first appeared on RheumNow, a news, information and commentary site dedicated to the field of rheumatology. Register to receive their free rheumatology newsletter.
Disclosures
Cush declared he has not received compensation as an advisor or consultant on this subject.
Primary Source
British Journal of Clinical Pharmacology
Khouri C, et al "Drug-induced Raynaud's phenomenon: beyond beta-blockers" Br J Clin Pharmacol 2016; DOI: 10.1111/bcp.12912.