Toxin for Treating Raynaud Conditions in Hands (The TORCH Study): A Systematic Review and Meta-analysis

Area of Science:

• Medical Science
• Vascular Biology
• Pharmacology

Background:

• Raynaud disease involves abnormal microcirculation in the hands.
• Botulinum toxin type A (BTX-A) is an emerging treatment for refractory Raynaud disease.

Purpose of the Study:

• To systematically review the efficacy of BTX-A for primary and secondary Raynaud disease.
• To evaluate BTX-A as a management strategy for Raynaud disease of the hands.

Main Methods:

• A systematic review adhering to PRISMA guidelines.
• Searched Ovid MEDLINE and Embase databases up to August 2023.
• Included 18 studies: RCTs, non-RCTs, case series, and cohort studies.

Main Results:

• Meta-analysis indicated an 81.95% probability of pain visual analog scale score improvement with BTX-A.
• A 79.37% probability of digital ulcer healing was observed with BTX-A intervention.
• BTX-A demonstrated potential in managing symptoms and promoting healing in Raynaud disease.

Conclusions:

• BTX-A delivery to digital vessels may effectively manage primary and secondary Raynaud disease.
• Further high-powered RCTs are necessary to quantify BTX-A efficacy for Raynaud disease of the hands.