Emerging treatments
Botulinum toxin type A
There are no large randomised controlled trials. One small trial assessed the efficacy of local injections of botulinum toxin type A versus placebo in improving blood flow to the hands of patients with RP secondary to scleroderma. It found some short-term benefit though it questioned its clinical meaningfulness, and blood flow was not significantly different at 4 months.[87] A 2023 systematic review and meta-analysis identified 13 studies investigating the use of botulinum toxin type A for treating RP. The findings indicated a reduction in both pain and impairment.[88] However, further randomised controlled trials with larger sample sizes are required.
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