When Secondary Raynaud's phenomenon occurs in the setting of a primarily inflammatory connective tissue disease or overt vasculitis with digital ischaemia, the clinical situation calls for a distinct therapeutic approach not applicable to uncomplicated cases.
This protocol covers patients with Secondary Raynaud's phenomenon who have a primarily inflammatory connective tissue disease — such as systemic lupus erythematosus — or who present with overt vasculitis accompanied by digital ischaemia. The presence of these conditions fundamentally changes the management framework compared to Raynaud's in the absence of underlying inflammatory or vasculitic disease.
In this inflammatory or vasculitic context, an immunomodulatory class of therapy becomes relevant — a direction not considered in straightforward presentations. Individual risk-benefit assessment is integral to the decision.
The full protocol specifies the options, decision criteria, and how to weigh individual patient factors. The complete regimen is available below.
DOI: 10.1177/1759720X17740074
However, in a patient with a primarily inflammatory connective tissue disease, for example systemic lupus erythematosus, or with overt vasculitis, the situation is different and corticosteroids or immunosuppressants might then be indicated.
Each case must be considered individually and the risks and benefits of corticosteroids and immunosuppressants carefully considered.
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