Botulinum toxin (BTX), widely known for its cosmetic and neurological applications, is emerging as a potential treatment for Raynaud’s phenomenon (RP), particularly when secondary to scleroderma. A newly published systematic review analyzed existing evidence, aiming to clarify the role of BTX in alleviating this debilitating vasospastic condition.
RP affects the small blood vessels in extremities such as fingers and toes, often triggered by cold or stress. In cases linked to scleroderma, a chronic autoimmune disease, RP can lead to severe complications and significantly impair quality of life. Despite various treatment options, there remains a need for more effective therapies.
The systematic review searched six major clinical databases, including Medline and Embase, compiling studies up to November 2023. Out of 890 entries, 19 studies met inclusion criteria, forming the basis for the analysis. The researchers evaluated the efficacy of BTX using three key measures: the Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score, visual analogue scale pain (VAS-P) score, and Raynaud’s condition score (RCS).
Results demonstrated significant improvements in Quick-DASH (p = 0.03) and VAS-P (p < 0.00001) scores, suggesting reduced disability and pain with BTX treatment. However, the RCS results were non-significant (p = 0.37), highlighting variability in outcomes. While the findings suggest BTX as a therapeutic option for RP secondary to scleroderma, the evidence remains insufficient to position it as a primary treatment. The review emphasized the need for further research to establish standardized dosing, injection techniques, and reliable outcome measures. With growing interest in BTX for vascular disorders, these insights pave the way for more robust clinical trials. For healthcare professionals managing scleroderma and RP, this study underscores the potential of BTX as part of a multidisciplinary approach. As research evolves, it may offer new hope for patients grappling with this challenging condition. Reference: Pang C et al. A systematic review of botulinum toxin as a treatment for Raynaud’s disease secondary to scleroderma. Clin Rheumatol. 2024. doi: 10.1007/s10067-024-07237-3. Anaya Malik | AMJ
