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Locally applied topical nitrates effective for Raynaud’s phenomenon

26 May 2018

Locally applied topical nitrates appear to be significantly effective in the treatment of primary and secondary Raynaud’s phenomenon (RP), according to a recent meta-analysis.

Pooled analysis from seven studies showed that topical nitrates had a significant moderate-to-large treatment effect on RP relative to placebo (standardized mean difference [SMD], 0.70; 95 percent CI, 0.36–1.05; p=0.00006). Significant heterogeneity was observed in this dataset.

Subsequent subgroup analyses showed that this effect was more pronounced in secondary (SMD, 0.95; 0.25–1.65; p=0.008) than in primary (SMD, 0.45; 0.05–0.85; p=0.0e) RP, but nevertheless remained significant in both cases. The secondary, but not the primary, RP group showed significant heterogeneity.

A post-hoc random effects meta-regression analysis used MQX-503, an alternative nitroglycerin gel vehicle, as a covariate and showed that it accounted for 73 percent of the heterogeneity in the main study group and 100 percent of the heterogeneity in the secondary RP subgroup.

MQX-503 yielded smaller effect sizes in the main study group (SMD, 0.36; 0.13–0.60; p=0.05) and secondary RP subgroup (SMD, 0.38; 0.09–0.67; p=0.01). This may be due to the different efficacies of the vehicle or the variations in trial designs, said researchers.

“Future comparative clinical trials may clarify whether differences between vehicles are attributable to a lower relative efficacy of MQX-503 vehicle or other factors,” they added.

For the present meta-analysis, researchers accessed the databases of the Cochrane library, Embase and Medline for trials that compared the efficacy of locally applied topical nitrates with placebo for RP. Efficacy was measured as subjective clinical improvements or objective improvement in digital blood flow.

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Most Read Articles
6 days ago
Percutaneous coronary intervention (PCI) is a safe procedure to perform on obese and morbidly obese patients, a recent study has shown.
Roshini Claire Anthony, 11 Jun 2018

Patients who received a combination of ticagrelor plus aspirin within 24 hours of undergoing coronary artery bypass grafting (CABG) had significantly improved saphenous vein graft patency rates 1 year post-procedure compared with those who only received aspirin, according to findings of the DACAB* trial.

3 days ago
Higher activity of plasma xanthine oxidase appears to be linked to insulin resistance and liver dysfunction among type 2 diabetes mellitus (T2DM) patients with metabolic syndrome (MetS), according to a recent Japan study.
Pearl Toh, 3 days ago
Drinking more water did not significantly slow down the decline in kidney function of patients with stage 3 chronic kidney disease (CKD) at 1 year compared with patients who maintained their daily water intake, the CKD WIT* randomized study suggests.