Are Topical Nitrates an Option to Treat Raynaud’s Phenomenon?

Raynaud’s phenomenon (RP) is a condition where smaller arteries that supply blood to the skin constrict excessively in response to cold, stress, or other factors, limiting blood supply to the affected area. Primary Raynaud’s phenomenon (PRP) occurs in up to 50% of the population and is not due to any underlying disease and does not result in any lasting damage. Secondary Raynaud’s phenomenon (SRP) is associated with autoimmune connective tissue disorders and may result in tissue damage. Locally applied topical nitrates can be used to treat both types of RP, but no study has specifically analyzed effectiveness based on whether the treatment is for PRP or SRP.

A recent meta-analysis was performed to establish the effects of local topical nitrates compared with placebo in treating PRP and SRP. The outcomes studied were combined clinical improvement and improved digital blood flow outcomes. The results demonstrated an overall significant treatment benefit for the use of topical nitrates for RP without serious side effects. When the subgroups studies were examined, the result showed a large treatment effect in SRP and moderate effect in PRP.

The authors conclude that while further studies may clarify the relative efficacy of various topical nitrate preparations, this meta-analysis supports the efficacy of topical nitrates in treating RP.