Nifedipine Vs Placebo For Treatment Of Chilblains

NewsBot · Sep 17, 2016

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Nifedipine vs Placebo for Treatment of Chronic Chilblains: A Randomized Controlled Trial
Ibo H. Souwer et al
Ann Fam MedSeptember/October 2016 vol. 14 no. 5 453-459

PURPOSE Nifedipine is commonly prescribed for the treatment of chilblains (pernio, perniosis) on the basis of observational studies and a single small, older clinical trial. We aimed to confirm the proposed superiority of oral nifedipine 60 mg per day over placebo for treatment of chronic chilblains in primary care.

METHODS We performed a randomized, placebo-controlled, double-blind, crossover trial, closely following the design of the older trial. A total of 32 patients with chronic chilblains were randomly assigned to nifedipine (30 mg controlled release twice a day) or placebo. The primary outcome was patient-reported complaints; the secondary outcome was patient-reported disability. Both were assessed from daily ratings on 100-mm visual analogue scales recorded in a diary. We took ambient temperatures into account and checked for a carry-over effect, and monitored for adverse effects.

RESULTS After 6 weeks of treatment, mean scores on the visual analogue scale on complaints showed a nonsignificant difference of 1.84 mm (95% CI, −6.67 to 2.99 mm) in favor of nifedipine (P = .44). Mean scores on the visual analogue scale on disability showed a nonsignificant difference of 0.56 mm (95% CI, −2.97 to 4.09 mm) in favor of placebo (P = .75). There was no carry-over effect of prior study treatment. Nifedipine was associated with significantly lower systolic blood pressure and a significantly higher incidence of edema.

CONCLUSIONS In our study, nifedipine was not superior to placebo for treating chronic chilblains. These findings contrast with those of the older study and do not support routine use of nifedipine for this condition.
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Admin2 · Sep 17, 2016

Related Topics:
Topical glyceryl trinitrate vs. oral nifedipine for chilblains
Pathophysiology of Chilblains
Chilblains Treatment

NewsBot · Feb 11, 2018

Sildenafil is an Effective Therapy for Treatment of Chilblain in Female
Patients with Bacteriological Study of Ulcerative Lesions
Prof. Dr. Khudhair Khalaf Al-Kayalli, M.B.Ch.B, F.I.B.M.S Burooj Mohammed Razooqi Al-aajem, M.Sc.
Mustansiriya Medical Journal Volume 16 Issue 3 December

Background: Chilblains, also called pernio or perniosis, are localized, tender,
inflammatory, erythematous, often itchy lesions, which may blistered or
ulcerated, caused by continued exposure to cold above the freezing point.
More commonly seen in children, women and persons with low body mass
index, with a genetic predisposition. Many prophylactic measures are used, and
therapeutic remedies for the treatment of developed chilblains, like nifedipine,
diltiazem, nicotinic acid derivatives, tamoxifen and minoxidil topically.
Objectives: The aim of the present study was to evaluate the effectiveness of
sildenafil in the treatment of chilblains in female patients.
Patients and methods: Sixty five female patients with chilblain were seen in a
private clinic in Kalar city, Al-Sulaimania Province, Iraq, for the period from the
first of October 2014 to the thirty of September 2016, their ages ranged from 10- 25 years (mean 16±8). The disease was diagnosed clinically and the patients
were evaluated for different data, and identification of bacteria which
complicate some patients with ulcerative lesions and all patients treated by
sildenafil tablet (50mg, once daily after meal), for 7-10 days and assisted
clinically (subjectively) for resolution of the disease.
Results: Sixty patients (92.3%) out of (65) studied patients shows complete
clearance of the disease clinically within 7-10 days of sildenafil treatment (50mg,
tablet, once daily orally after meal). Five patients (7.7%) shows partial
improvement of the disease with persistence of the signs and symptoms.
Staphylococcus aureus was isolated from 20(30.76%) patients. Ten patients
(15.4%) developed flushing and hotness of the face with nasal stiffness and 5
patients (7.7%) developing gastric upset.
Conclusion: It was concluded that sildenafil was an effective therapy for the
treatment of chilblain in female patients, although it was associated with some
side effects.
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NewsBot · Nov 14, 2019

Development of a UV-Stabilized Topical Formulation of Nifedipine for the Treatment of Raynaud Phenomenon and Chilblains
Ellen K. Wasan et al
Pharmaceutics 2019, 11(11), 594; https://doi.org/10.3390/pharmaceutics11110594

Raynaud’s Phenomenon is a vascular affliction resulting in pain and blanching of the skin caused by excessive and prolonged constriction of arterioles, usually due to cold exposure. Nifedipine is a vasodilatory calcium channel antagonist, which is used orally as the first-line pharmacological treatment to reduce the incidence and severity of attacks when other interventions fail to alleviate the condition and there is danger of tissue injury. Oral administration of nifedipine, however, is associated with systemic adverse effects, and thus topical administration with nifedipine locally to the extremities would be advantageous. However, nifedipine is subject to rapid photodegradation, which is problematic for exposed skin such as the hands. The goal of this project was to analyze the photostability of a novel topical nifedipine cream to UVA light. The effect of incorporating the photoprotectants rutin, quercetin, and/or avobenzone (BMDBM) into the nifedipine cream on the stability of nifedipine to UVA light exposure and the appearance of degradation products of nifedipine was determined. Rutin and quercetin are flavonoids with antioxidant activity. Both have the potential to improve the photostability of nifedipine by a number of mechanisms that either quench the intermolecular electron transfer of the singlet excited dihydropyridine to the nitrobenzene group or by preventing photoexcitation of nifedipine. Rutin at either 0.1% or 0.5% (w/w) did not improve the stability of nifedipine 2% (w/w) in the cream after UVA exposure up to 3 h. Incorporation of quercetin at 0.5% (w/w) did improve nifedipine stability from 40% (no quercetin) to 77% (with quercetin) of original drug concentration after 3 h UVA exposure. A combination of BMDBM and quercetin was the most effective photoprotectant for maintaining nifedipine concentration following up to 8 h UVA exposure.
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