Botulinum Toxins for the Treatment of Raynaud Phenomenon: A Systematic Review With Meta-analysis

J Clin Rheumatol. 2023 Aug 1;29(5):e92-e99. doi: 10.1097/RHU.0000000000001965. Epub 2023 Apr 4.

Abstract

Objective: Botulinum toxin (Btx) therapy has emerged as a potential treatment for patients with Raynaud phenomenon (RP) in recent years. This study aimed to investigate the efficacy and safety of Btx treatment for RP.

Methods: Databases of PubMed, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from their inception up to August 2022. Studies that reported Btx use for the treatment of RP were included. A meta-analysis was conducted for the Shortened version of the Disabilities of the Arm, Shoulder, and Hand (Quick DASH) score and visual analog scale pain score using a random-effects model.

Results: Thirteen full-text studies were included. The pooled standard mean changes for the visual analog scale pain score and QuickDASH score were -3.82 (95% confidence interval, -6.62 to -1.02) and 0.83 (95% confidence interval, -1.47 to -0.19), respectively. The 2 most common complications were injection site pain and intrinsic hand weakness.

Conclusions: The effect of Btx treatment on RP is promising based on current evidence. Nevertheless, more studies and randomized clinical trials with larger sample sizes are needed to confirm the current results.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Botulinum Toxins, Type A* / adverse effects
  • Hand
  • Humans
  • Neuromuscular Agents* / adverse effects
  • Pain
  • Raynaud Disease* / diagnosis
  • Raynaud Disease* / drug therapy

Substances

  • Botulinum Toxins, Type A
  • Neuromuscular Agents