{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:54:19Z","timestamp":1782604459842,"version":"3.54.5"},"reference-count":31,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T00:00:00Z","timestamp":1469664000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:p>Objective: To review the evidence for using intravenous (IV) epoprostenol to treat Raynaud\u2019s phenomenon (RP). Data Sources: The databases MEDLINE (1946 to March 2016), PubMed, and International Pharmaceutical Abstracts were searched using the terms epoprostenol, Flolan, Raynaud\u2019s disease, and CREST syndrome. Further literature sources were identified by reviewing article citations. Study Selection and Data Extraction: All English-language, clinical trials and case series evaluating IV epoprostenol for the management or treatment of RP were included. Lower-quality evidence were incorporated due to limited information. Data Synthesis: Seven small uncontrolled studies\/case series, 1 small placebo controlled study, and 1 larger randomized trial were identified and included. There was no consistent measurement of efficacy utilized, but improvements in hand temperature, RP attack duration and frequency were commonly associated with IV epoprostenol treatment (5 trials). There were conflicting data regarding effect sustainability, with 5 trials showing long-term effects and 3 showing immediate effects. Fewer ischemic ulcers developed during treatment with IV epoprostenol in 1 trial compared to conventional treatment. Ulcer healing ocurred in 2 trials. Common adverse effects included hypotension, headache, flushing, gastrointestinal symptoms, and jaw pain. Conclusions: Available evidence supports the use of IV epoprostenol for treatment of severe RP in patients refractory or intolerant to standard therapies. The dose, titration schedule, and duration of IV epoprostenol utilized in studies varied, but a conservative approach to initiation should be considered. Patients who do not respond to intermittent infusions and have severe digital ischemia may require more aggressive regimens.<\/jats:p>","DOI":"10.1177\/1060028016660324","type":"journal-article","created":{"date-parts":[[2016,7,27]],"date-time":"2016-07-27T20:39:43Z","timestamp":1469651983000},"page":"1060-1067","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Evidence for the Use of Epoprostenol to Treat Raynaud\u2019s Phenomenon With or Without Digital Ulcers"],"prefix":"10.1177","volume":"50","author":[{"given":"Joseph E.","family":"Cruz","sequence":"first","affiliation":[{"name":"Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA"},{"name":"Department of Pharmacy, Englewood Hospital Medical Center, Englewood, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Ward","sequence":"additional","affiliation":[{"name":"Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Anthony","sequence":"additional","affiliation":[{"name":"Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Chang","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center, Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun (Billy)","family":"Bae","sequence":"additional","affiliation":[{"name":"Englewood Hospital Medical Center, Englewood, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn R.","family":"Hermes-DeSantis","sequence":"additional","affiliation":[{"name":"Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA"},{"name":"Department of Pharmacy, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,7,28]]},"reference":[{"key":"bibr1-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2014.01.020."},{"key":"bibr2-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2005.08.004"},{"key":"bibr3-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-008-0792-4."},{"key":"bibr4-1060028016660324","unstructured":"Mark A, Joseph L. Arterial diseases of the extremities. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J eds. Harrison\u2019s Principles of Internal Medicine. 19th ed. New York, NY: McGraw-Hill; 2015. http:\/\/accesspharmacy.mhmedical.com.proxy.libraries.rutgers.edu\/content.aspx?bookid=1130&Sectionid=79744227. Accessed April 6, 2016."},{"key":"bibr5-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.096677."},{"key":"bibr6-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002069.pub5."},{"key":"bibr7-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.130658."},{"key":"bibr8-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-012-0303-1."},{"key":"bibr9-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199912)42:12<2646::AID-ANR21>3.0.CO;2-T"},{"key":"bibr10-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202836."},{"key":"bibr11-1060028016660324","unstructured":"GlaxoSmithKline. Flolan (epoprostenol) [package insert]. Research Triangle Park, NC: GlaxoSmithKline; 2014."},{"key":"bibr12-1060028016660324","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-120-3-199402010-00004"},{"key":"bibr13-1060028016660324","unstructured":"Actelion Pharmaceuticals US, Inc. Ventavis (iloprost) [package insert]. South San Francisco, CA: Actelion Pharmaceuticals US, Inc; 2013."},{"key":"bibr14-1060028016660324","unstructured":"Bayer New Zealand Limited. Ilomedin (iloprost) [data sheet]. Auckland, NZ: Bayer New Zealand Limited; 2012."},{"key":"bibr15-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-857X(03)00019-X"},{"key":"bibr16-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1982.tb00905.x"},{"key":"bibr17-1060028016660324","first-page":"43","volume":"3","author":"Rustin MH","year":"1984","journal-title":"Int Angiol"},{"key":"bibr18-1060028016660324","doi-asserted-by":"publisher","DOI":"10.3109\/03009748609098210"},{"key":"bibr19-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1016\/0952-3278(88)90118-4"},{"key":"bibr20-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1991.tb03883.x"},{"key":"bibr21-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1650182"},{"key":"bibr22-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(83)91624-0"},{"key":"bibr23-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1097\/00005344-199509000-00007"},{"key":"bibr24-1060028016660324","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-132-6-200003210-00002"},{"key":"bibr25-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp013013"},{"key":"bibr26-1060028016660324","unstructured":"European Medicines Agency. List of nationally authorized medicinal products. Active substance: iloprost (IV solution). http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Other\/2015\/10\/WC500195705.pdf. Accessed December 23, 2015."},{"key":"bibr27-1060028016660324","unstructured":"Drug Approval Package. Ventavis (Iloprost) inhalation solution. http:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/nda\/2004\/21-779_Ventavis.cfm. Accessed December 23, 2015."},{"key":"bibr28-1060028016660324","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp070024."},{"key":"bibr29-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2006.02.004"},{"key":"bibr30-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1191\/1358863x05vm579cr"},{"key":"bibr31-1060028016660324","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e289."}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1060028016660324","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1060028016660324","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1060028016660324","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:16:31Z","timestamp":1777374991000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1060028016660324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,28]]},"references-count":31,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2016,12]]}},"alternative-id":["10.1177\/1060028016660324"],"URL":"https:\/\/doi.org\/10.1177\/1060028016660324","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,28]]}}}