ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2701

Botulinum Toxin in the Management of Raynaud’s Phenomenon

Daniel Ennis1,2, Zareen Ahmad3, Keshini Devakandan1, Melanie A Anderson4 and Sindhu Johnson1, 1Toronto Scleroderma Program, Mount Sinai Hospital, Toronto Western Hospital, Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, ON, Canada, 2Rheumatology, University of British Columbia, Vancouver, BC, Canada, 3Toronto Scleroderma Program, Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada, 4University Health Network Library Services, Toronto General Hospital, Toronto, ON, Canada

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: , , ,

Session Information

Date: Tuesday, October 23, 2018

Title: Systemic Sclerosis and Related Disorders – Clinical Poster III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: The objectives of this study were to evaluate the effectiveness and safety of botulinum toxin injection in Raynaud’s phenomenon.

Methods: Medline and Embase databases were search to identify eligible studies. Studies reporting use of botulinum toxin, effectiveness measures and safety outcomes were included.

Results: A total of 421 patients with Raynaud’s were identified of which 324 (77%) were determined to have a secondary cause. A total of 202 subjects had systemic sclerosis (SSc) (33% limited SSc, 22% diffuse SSc, and 45% unknown subtype). Botulinum toxin A doses ranged from 10-200 units, administered with similar frequency to the palm (n=272) and digits (n=253). The mean duration of benefit was 6.28 months with a range of 1 month to 8.6 years. There were no attributable deaths reported with botulinum toxin use. The most common adverse event was intrinsic muscle weakness (32 total events, frequency of 7.6%), and pain in 2 subjects. Only a single subject experienced persistent muscle weakness and atrophy. Benefit was consistently demonstrated across a heterogeneous group of objective and subjective outcomes.

Conclusion: Botulinum toxin injection for the management of refractory primary and secondary Raynaud’s phenomenon, using various doses and injection techniques, was demonstrated to be generally safe. Effectiveness of this treatment is suggested by the consistently positive, although heterogeneous, objective and subjective outcomes. These findings support the ongoing study of botulinum toxin for the management of refractory Raynaud’s phenomenon.

Disclosure: D. Ennis, None; Z. Ahmad, None; K. Devakandan, None; M. A. Anderson, None; S. Johnson, Roche, Bayer, Boehringer, BMS, NIH, Merck, 9.

To cite this abstract in AMA style:

Ennis D, Ahmad Z, Devakandan K, Anderson MA, Johnson S. Botulinum Toxin in the Management of Raynaud’s Phenomenon [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/botulinum-toxin-in-the-management-of-raynauds-phenomenon/. Accessed .

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