Botulinum Toxin for the Treatment of Intractable Raynaud Phenomenon

Shwe, Samantha; Sharma, Aditi; Chahal, Harvind S.; Doan, Linda; Rojek, Nathan W.

doi:10.12788/cutis.0355

Cited by 2 publications

(14 citation statements)

References 11 publications

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“…43 This is a measure of skin thickness that is usually used to estimate disease activity in systemic sclerosis patients. 50 No Improvement There were 14.3% (6 of 42) of the studies 1,12,13,16,18,35 that reported 3.5% (15 of 425) of all patients showing no subjective improvement after the use of BT for RP (Table 3). Diagnoses for these patients included scleroderma/systemic sclerosis, systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), mixed connective tissue U BT-A were injected into the hand.…”

Section: Positive Resultsmentioning

confidence: 98%

“…9,15,25,26,43,44 There were 7 case series', including a range of 2 to 11 patients. 4,20,28,31,[35][36][37] There were 15 single case reports, 1,2,5,10,14,17,21,23,24,27,29,32,33,40,46 1 piece of original research, 38 and 1 clinical trial. 45 The largest study was a randomized trial by Motegi et al 26 in 2017, which included 45 patients.…”

Section: Resultsmentioning

confidence: 99%

“…The dose of BT-A injected per hand had the wide range of 10 to 300 units, and no injection site stands out among these studies as a disproportional cause of complications. However, Fregene et al 11 noticed that most of their cases of muscle weakness occurred when injections Subjective patient reported outcomes 23 1,2,4,5,[10][11][12][13][14]16,17,21,23,[27][28][29]32,33,[35][36][37]40,42,46 VAS 22 9,11,16,[18][19][20]22,[24][25][26][29][30][31]34,[37][38][39]41,[43][44][45][46] Ulcer healing 21 4,[11]…”

Section: Vas Ulcer Healing Capillaroscopy 1 Momentioning

confidence: 99%

“…There are 8 studies in Table 1 that treated a total of 12 patients with RP of the feet and toes with BT-A injections. 1,4,28,29,37,39,42,46 Nine of these patients had secondary RP of the toes, and the type of the remaining 3 was unspecified. Doses ranged from 10 U BT-A per foot to 210 U BT-A per foot at a single injection session, and there were no adverse effects reported for any of these patients.…”

Section: Rp Of the Feetmentioning

confidence: 99%

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The Use of Botulinum Toxin in Raynaud Phenomenon

2023

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Background Raynaud phenomenon (RP) is a vasospastic condition of the digits that can be primary or secondary to systemic disease. Symptoms are triggered by cold or stress and can cause pain and skin color changes. The chronic ischemia may lead to necrosis, ulceration, and amputation. There are no Food and Drug Administration–approved treatments and cases refractory to pharmacologic and surgical treatments are difficult to control. Local botulinum toxin injections have been increasingly used in the treatment of Raynaud disease and have shown promising results. Aim of the study To examine the outcomes, techniques, and complications of botulinum toxin use for the treatment of Raynaud disease. Methods The PubMed database was queried using “botulinum toxin” AND “Raynaud phenomenon” as title key words. Preferred reporting items for systematic reviews and meta-analysis criteria were used. Additional articles were selected while reviewing the references of the articles from PubMed. No time restrictions were followed. Articles of all languages were included. Articles were analyzed for study type, demographics, diagnosis/inclusion criteria, treatment methods, outcome measures, length of follow-up, results, and complications. A positive outcome was defined as subjective improvement in symptoms and/or improvement in the outcome measures. A poor outcome was defined as harm done to the patient by the injection that would not have occurred otherwise. Results Forty-two clinical studies describing the use of botulinum toxin for Raynaud's phenomenon were found. A total of 425 patients with primary or secondary Raynaud's were treated, with ages ranging from 14 to 91 years. There were 342 women and 81 men, with a female-to-male ratio of 38:9. Outcomes were positive in 96.2% of patients. There were 14.2% of the studies that reported 3.5% of all patients showing no subjective improvement. A single study reported a poor outcome for 1 patient. There were 40.5% of the studies that reported complications, affecting 20.2% of all patients. The most frequently reported complication was transient hand weakness, affecting 44.2% of patients with complications and 8.9% of total patients. Weakness resolved in hours to months after injection. Pain at the injection site lasting minutes to days was reported in 40.7% of patients with complications, and 8.2% of total patients. Conclusions Botulinum toxin treatment for RP is effective. Complications are minor and self-limiting.

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Section: Positive Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Vas Ulcer Healing Capillaroscopy 1 Momentioning

confidence: 99%

Section: Rp Of the Feetmentioning

confidence: 99%

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The Use of Botulinum Toxin in Raynaud Phenomenon

2023

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“…Although numerous publications demonstrated a positive effect of BoNT-A on RP [36][37][38][39][40], this review article will mainly focus on patients who had RP-associated ulcers. Based on the literature search, 12 articles (case reports, retrospective case series, and prospective case series) with a total of 104 patients who had RP-associated ulcers were identified (Table 1) [41][42][43][44][45][46][47][48][49][50][51][52].…”

Section: Ischemic Ulcers Secondary To Raynaud's Phenomenon (Rp)mentioning

confidence: 99%

Botulinum Toxin Type A for the Treatment of Skin Ulcers: A Review Article

Winayanuwattikun

Vachiramon

2022

Toxins

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The normal biological wound healing process consists of three precisely and highly programmed phases that require optimal conditions including internal and external factors. Any negative factors that disrupt the sequence or time frame of the healing mechanism can result in a non-healing wound or chronic ulcers. Botulinum neurotoxin A (BoNT-A) which is generally known as anti-contraction of muscles has been reported as a successful treatment in various types of chronic ulcers. The aim of this study is to review the outcome of treatment with BoNT-A for chronic skin ulcers. The results demonstrated some positive effects of BoNT-A on chronic ulcers. Ischemic ulcers secondary to Raynaud’s phenomenon seem to be the most promising type of ulcers that have benefited from BoNT-A. The rationale behind using BoNT-A to fasten the wound healing process is also discussed. Further clinical trial studies should be conducted to affirm the efficacy of wound healing using BoNT-A administration.

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Botulinum Toxin for the Treatment of Intractable Raynaud Phenomenon

Cited by 2 publications

References 11 publications

The Use of Botulinum Toxin in Raynaud Phenomenon

The Use of Botulinum Toxin in Raynaud Phenomenon

Botulinum Toxin Type A for the Treatment of Skin Ulcers: A Review Article

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