Ab1804

Long-term low molecular weight heparin therapy for severe Raynaud's phenomenon: A pilot study

C.P. Denton, K. Howell, R.J. Stratton, C.M. Black

Centre for Rheumatology (Royal Free Campus), Royal Free and University College Medical School, London, UK.

ABSTRACT
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). End-points 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.

Conclusion
This study suggests that LMW heparin therapy is well tolerated, and potentially beneficial, in patients with severe Raynaud's phenomenon, and justifies further evaluation.

Key words
Scleroderma, laser Doppler flowmetry, clinical trial, anticoagulant.

Funding for this study was provided by the Stanley Thomas Johnson Foundation (CPD), Ernst Schering Research Foundation (RJS), the Arthritis Research Campaign and the Raynaud's and Scleroderma Association.

Please address correspondence and reprint requests to: Professor Carol M Black, MD, FRCP, Centre for Rheumatology (Royal Free Campus), Royal Free and University College School of Medicine, Rowland Hill Street, London NW3 2PF, UK.
E-mail: black@rfhsm.ac.uk