Topical Nitrates Effective for Treating Raynaud's Phenomenon

Large treatment effect in secondary RP
Large treatment effect in secondary RP

Topical nitrates may be beneficial for patients with primary and secondary Raynaud's phenomenon, according to a systematic review published in the Journal of the American Academy of Dermatology

For this study, researchers performed a meta-analysis to examine the effects of local topical nitrates in primary and secondary Raynaud's phenomenon with respect to parameters such as digital blood flow and clinical severity. Trials that compared local topical nitrates vs placebo were included in the analysis.

A total of 7 trials involving 346 patients were identified; nitroglycerin ointments were used in 4 trials, MQX-503 in 2 trials, and a compounded nitrite in 1 trial. 

The results showed a moderate to large treatment effect in Raynaud's phenomenon (standardized mean difference [SMD] 0.70; P<0.0001), with subgroup analysis indicating a larger treatment effect for secondary Raynaud's phenomenon (SMD 0.95; P=0.008) compared to primary Raynaud's phenomenon (SMD 0.45; P=0.03). 

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While the study had its limitations, including the use of multiple topical preparations and different outcome assessments, the authors conclude that "local topical nitrates have significant efficacy in the treatment of both primary and secondary Raynaud's phenomenon."

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