A systematic review and meta-analysis of the effects of topical nitrates in the treatment of primary and secondary Raynaud's phenomenon - 12/05/18
Abstract |
Background |
Multiple placebo-controlled trials have assessed locally applied topical nitrate preparations in treating Raynaud's phenomenon (RP).
Objectives |
The objective of this meta-analysis was to assess the effects of local topical nitrates in primary and secondary RP with respect to a combined end point integrating parameters of digital blood flow and clinical severity.
Methods |
A systematic review was performed using MEDLINE, Embase, and the Cochrane library. Only trials comparing locally applied topical nitrates with placebo comparators were included. Studies were appraised for bias by 2 independent reviewers.
Results |
A total of 7 placebo-controlled trials including 346 patients were used in the meta-analysis; 4 trials used nitroglycerin ointments, 2 used the nitroglycerin gel vehicle MQX-503, and 1 used compounded nitrite. The meta-analysis results supported a moderate-to-large treatment effect in RP (standardized mean difference [SMD] = 0.70; 95% CI, 0.35-1.05; P < .0001). Subgroup analyses showed a large treatment effect in secondary RP (SMD = 0.95; 95% CI, 0.25-1.65; P = .008) and moderate effect in primary RP (SMD = 0.45; 95% CI, 0.05-0.85; P = .03).
Limitations |
Limitations include the inclusion of multiple topical nitrate preparations and integration of different outcomes assessments.
Conclusion |
Local topical nitrates have significant efficacy in the treatment of both primary and secondary RP.
Le texte complet de cet article est disponible en PDF.Key words : connective tissue disease, medical dermatology, meta-analysis, Raynaud's phenomenon, scleroderma
Abbreviations used : NO, PDE-5, PRP, RP, SMD, SRP
Plan
| Funding sources: None |
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| Conflicts of interest: None disclosed. |
Vol 78 - N° 6
P. 1110 - juin 2018 Retour au numéro
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