Therapeutic Effect of Botulinum Toxin Type A on Ischemic Attack in Hospitalized Scleroderma Patients

Background/Aims: Raynaud's phenomenon causes pain, by reversible constriction of the arteries in the fingers. However, the treatment of Raynaud's phenomenon is one of the clinical issues. Recent studies have shown that botulinum toxin is considered as a potentially effective therapeutic option for improving the finger blood circulation in patients with accelerated Raynaud's phenomenon. In this study, we evaluated the effect of botulinum toxin A (Botox) on accelerated Raynaud’s phenomenon in Scleroderma.
Methods: In this prospective study, 11 patients with scleroderma referred due to the aggravated Raynaud's were included. For all patients, questionnaires were filled up and physical examination was performed separately for both treatment and control hands, and then the Botox were randomly injected in one hand and normal saline with the same volume on the another hand.
Results: The results of this study showed that there was a significant difference in the Mc- Cabe cold score between the two hands, in the first and second month after the intervention (P = 0.001, P = 0.003, respectively). While, the mean of the Raynaud's score and the Quick-Dash score were significantly different only 2 months after the intervention (p<0.05). Despite the decrease in the average frequency of attacks, the severity of pain, discoloration, and the duration of the Raynaud phenomenon, no significant difference was observed in the number of total ulcers between two hands (P>0.05). Conclusion: Together, botulinum toxin type A could retrieve the hand function, the cold sensitivity, and pain feeling caused by Raynaud's syndrome