Latest news with #RaynaudPhenomenon
Medscape
2 days ago
- Health
- Medscape
Raynaud Phenomenon Tied to Elevated Cardiovascular Risk
TOPLINE: Individuals with Raynaud phenomenon without underlying systemic autoimmune rheumatic diseases had higher risks for major adverse cardiovascular events (MACE) and venous thromboembolism than did a comparator group with irritable bowel syndrome (IBS), regardless of age. METHODOLOGY: Researchers conducted a retrospective cohort study to examine whether individuals with Raynaud phenomenon experienced cardiovascular outcomes more frequently than those without the condition. They included 30,088 individuals younger than 45 years and 60,145 aged 45 years or older with Raynaud phenomenon without systemic autoimmune rheumatic diseases , identified from electronic health records of centers in North America between March 2005 and March 2025. An equal number of propensity score-matched individuals with IBS were assigned as comparators to both age categories. The researchers chose IBS as a comparator group because, like Reynaud phenomenon, it is common in younger and female individuals. In addition, it is not known to be associated with adverse cardiovascular outcomes. Co-primary outcomes were MACE and venous thromboembolism, evaluated over mean follow-up durations of 4.4-4.9 years across groups. TAKEAWAY: Among individuals younger than 45 years, those with Raynaud phenomenon had higher risks for MACE (hazard ratio [HR], 1.23; 95% CI, 1.07-1.42) and venous thromboembolism (HR, 1.32; 95% CI, 1.20-1.46) than did those with IBS. Similar results were observed among individuals aged 45 years or older, where those with Raynaud phenomenon had higher risks for MACE (HR, 1.17; 95% CI, 1.13-1.20) and venous thromboembolism (HR, 1.20; 95% CI, 1.14-1.26) than those with IBS. Individuals with Raynaud phenomenon had higher risks for secondary outcomes such as stroke, any cardiovascular disease, and pulmonary embolism noted in both age categories. IN PRACTICE: '[This] data substantiates several previous reports of an increased risk of CVD [cardiovascular disease] in individuals with RP [Raynaud phenomenon], and provides further supporting evidence of a similar risk of VTE [venous thromboembolism],' the authors of the study wrote. 'Taken together our findings lend further support to suggest that RP (in the absence of any secondary SARD [systemic autoimmune rheumatic disease]) could be a manifestation of subclinical CVD. Of course, this requires further confirmation including prospective studies,' they added. SOURCE: This study was led by Michael Hughes, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom. It was published online on August 5, 2025, in Seminars in Arthritis and Rheumatism. LIMITATIONS: Diagnostic codes were used for identifying the conditions; however, misclassification bias may be possible. Details such as digital ischemic episodes were not available for individuals with Raynaud phenomenon and age of onset and family history were not assessed. Many oral drug treatments for Raynaud phenomenon are vasodilators also used for systemic hypertension; hence, the primary indication was unclear. DISCLOSURES: One author reported receiving support from the National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre. Another author reported receiving support from NIHR Clinical Lectureship, and working at centers supported by Versus Arthritis and NIHR Manchester Biomedical Research Centre. Two authors reported receiving research funding, speaker fees, honoraria, and consultancy fees and having other financial ties with multiple companies including Janssen, Sanofi, and Novartis. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
18-06-2025
- Health
- Medscape
Puffy Fingers or Hands Often Precede Raynaud in SSc
While Raynaud phenomenon is often the initial clinical manifestation of systemic sclerosis (SSc), over 30% of patients in two large US cohorts presented first with other manifestations — predominantly puffy fingers and hands. These patients exhibited more severe skin disease and increased joint contractures than those showing Raynaud as their initial symptom. METHODOLOGY: Researchers analyzed data from two large US cohorts to assess the clinical features of SSc in patients whose first manifestation was a non-Raynaud symptom. They included 1377 patients older than 18 years with SSc who were diagnosed within 5 years of their first non-Raynaud symptom and met standardized SSc classification criteria. Date on baseline demographics, clinical features (such as skin involvement, joint contractures, and tendon friction rubs), and the presence of specific autoantibodies were collected. Serologic testing was performed for antinuclear antibodies and SSc-specific autoantibodies using HEp-2 indirect immunofluorescence assay and other specific laboratory or clinical assays. TAKEAWAY: In both the cohorts, 31%-44% of patients had a non-Raynaud symptom — most commonly puffy fingers or hands — as their initial sign of SSc preceding the onset of Raynaud phenomenon. Black patients were more likely to present with non-Raynaud symptoms as their first manifestation than patients from other racial and ethnic backgrounds. Patients who initially presented with non-Raynaud symptoms had a significantly higher prevalence of diffuse cutaneous involvement, joint contractures, and tendon friction rubs at baseline. In both cohorts, RNA polymerase III antibody was significantly more prevalent in patients who presented with non-Raynaud phenomenon first than in those who presented with Raynaud phenomenon first ( P <.01 for both cohorts). IN PRACTICE: "Future research aimed at understanding and/or treating patients in the early stages of SSc should be inclusive of those presenting without [Raynaud phenomenon] if other risk features (eg, puffy fingers/hands, abnormal nailfold capillaries, skin tightening, tendon friction rubs, positivity for ANA and SSc-associated specific autoantibodies) are present," the authors wrote. SOURCE: This study was led by Iqtidar Hanif, MD, MS, UTHealth Houston Division of Rheumatology, Houston, Texas. It was published online on May 19, 2025, in Arthritis & Rheumatology . LIMITATIONS: The study relied on patient recall, which may have introduced bias and imprecision in reporting symptom onset. There was also a lack of standardization across sites in assessing the presence of Raynaud phenomenon. Additionally, the findings may be influenced by referral bias, as patients seen at academic medical centers are often referred by other rheumatologists or seek second opinions independently. DISCLOSURES: One of the cohorts was supported by the Scleroderma Research Foundation, and some authors reported receiving grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Some authors reported receiving financial support, grants, or consulting fees from various pharmaceutical companies.
