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.

中文翻译：

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对局部硝酸盐治疗原发性和继发性雷诺现象的系统评价和荟萃分析

背景

多项安慰剂对照试验评估了局部使用的局部硝酸盐制剂在治疗雷诺现象（RP）中的作用。

目标

这项荟萃分析的目的是评估相对于数字血流和临床严重程度的综合终点参数而言，原发性和继发性RP中局部局部硝酸盐的影响。

方法

使用MEDLINE，Embase和Cochrane库进行了系统的评价。仅包括将局部使用的局部硝酸盐与安慰剂比较剂进行比较的试验。由2位独立审阅者对研究的偏倚进行了评估。

结果

荟萃分析共使用了7项安慰剂对照试验，包括346例患者。4项试验使用了硝酸甘油软膏，2项使用了硝酸甘油凝胶载体MQX-503，1项使用了复合亚硝酸盐。荟萃分析结果支持RP的中到大型治疗效果（标准平均差[SMD] = 0.70； 95％CI，0.35-1.05；P  <.0001）。亚组分析显示，在继发性RP中有较大的治疗效果（SMD = 0.95; 95％CI，0.25-1.65; P  = .008 ），而在原发性RP中具有中等效果（SMD = 0.45; 95％CI，0.05-0.85; P  =。 03）。

局限性

局限性包括纳入多种局部硝酸盐制剂以及整合不同的结果评估。

结论

局部局部硝酸盐在治疗原发性和继发性RP中均具有显着疗效。