Long-term low molecular weight heparin therapy for severe Raynaud's phenomenon: a pilot study.
OBJECTIVE
To investigate tolerability and efficacy of low molecular weight (LMW) heparin therapy in patients with severe Raynaud's phenomenon.


METHODS
A prospective parallel group study comparing patients receiving regular subcutaneous LMW heparin (n = 16) with a matched control group (n = 14). Endpoints were change in Raynaud's attack severity, non-invasive vascular studies or serum levels of circulating soluble adhesion molecules.


RESULTS
There was overall improvement in Raynaud's attack severity during heparin therapy (p = 0.0002). This was observed after 4 weeks, and was maximal by 20 weeks. Mean finger blood flow recovery time improved, and serum levels of circulating ICAM-1, VCAM-1 and E-selectin were lower at completion of heparin therapy, but changes did not reach statistical significance.


CONCLUSIONS
This study suggests that LMW heparin therapy is well tolerated, and potentially beneficial, in patients with severe Raynaud's phenomenon, and justifies further evaluation.
Denton
C P
CP
Centre for Rheumatology (Royal Free Campus), Royal Free and University College Medical School, London, UK.
Howell
K
K
Stratton
R J
RJ
Black
C M
CM
D000328:Adult; D019040:E-Selectin / Q000097:blood; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005385:Fingers / Q000098:blood supply / Q000000981:diagnostic imaging; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D017078:Laser-Doppler Flowmetry; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011928:Raynaud Disease / Q000188:drug therapy* / Q000209:etiology; D012039:Regional Blood Flow / Q000187:drug effects; D012595:Scleroderma, Systemic / Q000150:complications; D014463:Ultrasonography; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D019040:E-Selectin; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1