Botulinum toxin type A in the treatment of Raynaud's phenomenon: A three-year follow-up study

Abstract

Objective: Raynaud's phenomenon consists of vasospastic disease of the digital arteries afterexposure to cold or stress. It causes an important reduction in the patient's quality of life whensevere. The available treatments do not always offer favorable results.Methods: A 3-year retrospective study was presented. A total of 15 patients with severe Ray-naud's phenomenon who required infiltration with botulinum toxin type A participated in thestudy. In the first and follow-up visits (30 min, 7 days, 3 months, 6 months, and annual), theoverall response by the patient was assessed as was the reduction in the number of weeklyepisodes of Raynaud's phenomenon, improvement in pain by means of the Visual AnalogueScale, and resolution of ulcers and necrosis as efficacy variables.Results: A total of 15 patients were included in the study. After 30 min of infiltration, the im-mediate results showed a very good perception of response in four patients. After 1 monthof treatment, eight patients had obtained and maintained a very good response, persistingthroughout the study. A statistically significant reduction in pain was obtained, as well as thenumber of weekly episodes of Raynaud's phenomenon. Of the seven patients with basal ul-cers, five were completely healed at 3 months. Of the patients, 64.3% showed an overall satis-faction level of >8 at the end of treatment. No serious adverse events were observed.Conclusion: Botulinum toxin is a useful treatment for severe Raynaud's phenomenon that isgenerally well tolerated. Its mechanism of action is not based exclusively on vasodilation. Fur-ther studies are necessary to define the ideal patient for this treatment, the most appropriatemethod of administration, and the number of units and frequency of the infiltrations.