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Botox may effectively treat severe Raynaud’s phenomenon
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Botox was found to be effective in the treatment of severe Raynaud’s phenomenon, according to the results of a study.
Seven patients with severe Raynaud’s phenomenon (RP) who did not respond appropriately to conventional therapy were recruited. Three patients presented digital ulcers at baseline. Patients were excluded in the presence of allergy to Botox (onabotulinumtoxinA, Allergan), active infection at the injection site, prior digital sympathectomy or pregnancy.
Depending on the severity of RP, four to eight units of onabotulinumtoxinA were injected into the lateral and medial aspect of the base of each finger, excluding the thumb.
Follow-up took place with six patients; one death occurred 3 days following injection due to peritonitis. Three patients reported no improvement after 30 minutes, two patients reported slight improvement and two patients reported significant improvement.
At 1 week and at 1 month of follow-up, two patients reported no improvement, whereas four reported significant improvement. Patients who reported no improvement had normal Doppler ultrasound and capillaroscopy test results and had fewer symptoms at baseline.
Of the variables that improved, pain was the most remarkable, according to the researchers, and a state of healing was observed after 1 month in the patients who had digital ulcers at baseline. Healing was observed after 1 week in two patients and at 1 month in the third patient.
Adverse events include reports by three patients of mild weakness following the injection and one reported mild thenar-eminence pain that lasted for several days. – by Shirley Pulawski
Reference:
Ruiz Gutiérrez L, et al. Paper #AB0713. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.
Disclosure: The researchers report no relevant financial disclosures.