Thromb Haemost 1985; 54(02): 490-494
DOI: 10.1055/s-0038-1657880
Original Article
Schattauer GmbH Stuttgart

Evening Primrose Oil (Efamol) in the Treatment of Raynaud’s Phenomenon: A Double Blind Study

J J F Belch
The Centre for Rheumatic Diseases, Department of Medicine and Vascular Surgery, Royal Infirmary, Glasgow, UK
,
B Shaw
The Centre for Rheumatic Diseases, Department of Medicine and Vascular Surgery, Royal Infirmary, Glasgow, UK
,
A O’Dowd
The Centre for Rheumatic Diseases, Department of Medicine and Vascular Surgery, Royal Infirmary, Glasgow, UK
,
A Saniabadi
The Centre for Rheumatic Diseases, Department of Medicine and Vascular Surgery, Royal Infirmary, Glasgow, UK
,
P Leiberman
The Centre for Rheumatic Diseases, Department of Medicine and Vascular Surgery, Royal Infirmary, Glasgow, UK
,
R D Sturrock
The Centre for Rheumatic Diseases, Department of Medicine and Vascular Surgery, Royal Infirmary, Glasgow, UK
,
C D Forbes
The Centre for Rheumatic Diseases, Department of Medicine and Vascular Surgery, Royal Infirmary, Glasgow, UK
› Author Affiliations
Further Information

Publication History

Received 12 February 1985

Accepted 31 May 1985

Publication Date:
18 July 2018 (online)

Summary

Prostaglandin E1 (PGE1) and prostacyclin have been used in Raynaud’s phenomenon (RP) but are unstable and require intravenous administration. An alternative approach is to stimulate the body’s own PGE1 production via administration of the precursor essential fatty acid. We studied the effect of 12 capsules/day of evening primrose oil (EPO) on the manifestations of RP. 21 patients received a two week course of placebo, thereafter 11 received EPO for 8 weeks and 10 patients received placebo. As the weather worsened the placebo group experienced significantly more attacks than the EPO group. Visual analogue scales assessing the severity of attacks and coldness of hands improved in the EPO group. No changes were seen in either group in hand temperatures and cold challenge plethysmography. Blood tests showed some antiplatelet effects of the drug. In conclusion patients receiving EPO benefited symptomatically. This was not matched however by any change in objective assessment of blood flow, although changes in platelet behaviour and blood prostanoids were observed.

 
  • References

  • 1 Martin MFR, Dowd PN, Ring EFJ, Cooke ED, Dieppe PA, Kirby JDT. Prostaglandin E1 infusions for vascular insufficiency in progressive systemic sclerosis. Ann Rheum Dis 1980; 40: 350-352
  • 2 Belch JJF, Newman P, Drury JR, McKenzie F, Capell H, Leiberman P, Forbes CD, Prentice CRM. Intermittent prostacyclin infusions in patients with Raynaud’s Syndrome. Lancet 1983; 1: 313-315
  • 3 Fisher JM, Donegan DR, Leon H, Willis AL. Effects of prostaglandins and their precursors in some tests of haemostatic function. Progr Lipid Res 1982; 20: 799-805
  • 4 Scholkens BA, Gehring D, Schlotte V, Weithmann U. Evening Primrose Oil, a dietary prostaglandin precursor, diminishes vascular reactivity to renin and angiotensin II in rats. Prost Leuk Med 1982; 8: 273-285
  • 5 Begent NA, Born GVR, Shafi S, Thorngren M. Increased bleeding time associated with decreased vascular contractility in rats fed polyunsaturated lipids. J Physiol 1983; 349: 69P
  • 6 Horrobin DF. The regulation of prostaglandin biosynthesis; negative feedback mechanisms and the selective control of formation of 1 and 2 series prostaglandins: relevance to inflammation and immunity. Med Hypotheses 1980; 6: 687-709
  • 7 Ring EFJ, Bacon PA. Quantitative thermographic assessment of inositol nicotinate therapy in Raynauds phenomenon. J Int Med Res 1977; 5: 217-222
  • 8 Acciarri I, Camevale F, Della Selva A. Thermography in the hand angiopathy from vibrating tools. Acta Therm 1976; 1: 18-28
  • 9 Nielsen SL, Lassen NA. Measurement of digital arterial blood pressure after cooling. J Appl Physiol 1977; 43: 907-910
  • 10 Born GVR. Aggregation of platelets by ADP and its reversal. Nature 1962; 194: 927-931
  • 11 Belch JJF, Greer IA, McLaren M, Saniabadi AR, Miller S, Sturrock RD, Forbes CD. The effects of intravenous infusion of ZK36-374, a synthetic prostacyclin derivative, on normal volunteers. Prostaglandins 1984; 28: 67-78
  • 12 McLaren M, Belch JJF, Forbes CD. The development of a radioimmunoassay for measurement of prostacyclin metabolites in unextracted plasma. Thromb Res 1985; 37: 177-183
  • 13 Granstrom E, Kindahl H. Radioimmunoassay of prostaglandins and thromboxanes. In: Advances in Prostaglandin and Thromboxane Research. Vol.5. Frolich JC. (ed). Raven Press; New York: 1978: 119-127
  • 14 Clauss A. Gerinnungsphysiologische Schnellmethode zur Bestimmung des Fibrinogens. Acta Haematol 1957; 17: 237-251
  • 15 Alkjaersig N, Fletcher AP, Sherry S. The mechanism of clot dissolution by plasmin. J Clin Invest 1959; 38: 1086-1088
  • 16 Kluft C, Brakman P, Veldhuyzen-Stalk EC. Screening of the fibrinolytic activity in plasma euglobulin fractions on the fibrin plate. In: Progress in chemical fibrinolysis and thrombolysis. Davidson JF, Samama MM, Desnoyers PC. (eds). Raven Press; New York: 1976. 2 57-62
  • 17 Belch JJF, McLaren M, Anderson J, Lowe GDO, Sturrock RD, Capell HA, Forbes CD. Increased prostacyclin metabolites and decreased red cell deformability in patients with systemic sclerosis and Raynaud’s Syndrome. Prost Leuk Med 1985; 17: 1-9
  • 18 Horrobin DF, Jenkins K, Manku MS. Raynaud’s phenomenon, histamine and prostaglandins. Lancet 1983; 1: 747-748
  • 19 Fiocco U, Calo L, Piccoli A, Del TorreM, Cantaro S, Baggio B, Glorioso S, Borsatti A, Todesco S. Urinary prostaglandins in scleroderma, p 768 in Abstracts of International Prostaglandin Meeting. Florence. 1982
  • 20 Sanders TAB, Vichers M, Haines AP. Effect on blood lipids and haemostasis of a supplement of cod-liver oil, rich in eicosapentaenoic and dodecosahexaenoic acids, in healthy young men. Clin Sci 1981; 61: 317-324
  • 21 Dyerberg J, Bang HO. Haemostatic function and platelet polyunsaturated fatty acids in Eskimos. Lancet 1979; 2: 433-435
  • 22 Kobayashi S, Hirai A, Terano T, Hamazaki T, Tamura Y, Kumagai A. Reduction in blood viscosity by eicosapentaemoic acid. Lancet 1981; 2: 197
  • 23 Horrobin DF. The role of essential fatty acids and prostaglandins in the premenstrual syndrome. J Reprod Med. (in press).