Emerging treatments
OnabotulinumtoxinA
There are no large randomized controlled trials. One small trial assessed the efficacy of local injections of onabotulinumtoxinA (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 onabotulinumtoxinA (botulinum toxin type A) for treating RP. The findings indicated a reduction in both pain and impairment.[88] However, further randomized controlled trials with larger sample sizes are required.
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