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Long-term low molecular weight heparin therapy for severe Raynaud's phenomenon: a pilot study
C P Denton1, K Howell, R J Stratton
1Centre for Rheumatology (Royal Free Campus), Royal Free and University College Medical School, London, UK.
Objective:
To investigate tolerability and efficacy of low molecular weight (LMW) heparin therapy in patients with severe Raynaud's phenomenon.
Methods:
A prospective parallel group study comparing patients receiving regular subcutaneous LMW heparin (n = 16) with a matched control group (n = 14). Endpoints were change in Raynaud's attack severity, non-invasive vascular studies or serum levels of circulating soluble adhesion molecules.
Results:
There was overall improvement in Raynaud's attack severity during heparin therapy (p = 0.0002). This was observed after 4 weeks, and was maximal by 20 weeks. Mean finger blood flow recovery time improved, and serum levels of circulating ICAM-1, VCAM-1 and E-selectin were lower at completion of heparin therapy, but changes did not reach statistical significance.
Conclusion:
This study suggests that LMW heparin therapy is well tolerated, and potentially beneficial, in patients with severe Raynaud's phenomenon, and justifies further evaluation.