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Low Level Laser Therapy in Primary Raynaud's Phenomenon — Results of a Placebo Controlled, Double Blind Intervention Study
MIRKO HIRSCHL, REINHOLD KATZENSCHLAGER, CLAUDIA FRANCESCONI, and MICHAEL KUNDI
ABSTRACT. Methods. Forty-eight patients were included in a randomized placebo controlled, double blind crossover study. Laser and sham therapy each were applied 5 days a week for 3 weeks. Clinical symptoms, exposure to triggers, and frequency and intensity of attacks were recorded in diaries. Results of infrared thermography before onset and at the end of both irradiation sequences were evaluated. Primary endpoint was the average intensity of attacks; secondary endpoints were average number of attacks and thermography results. Age, sex, duration of symptoms, age at onset of symptoms, evoking conditions other than cold, maximum temperature drop after cold provocation, and rewarming time after cold provocation were tested as potential predictors. Results. Number of attacks and their intensity were significantly reduced during laser therapy compared to sham treatment. Thermographic parameters did not reach statistical significance. In a stepwise multiple regression analysis, evoking conditions other than cold (stress, wetness as additional triggers), rewarming time, and temperature decrease after cold provocation were significant predictors of therapeutic efficacy. Conclusion. Low level laser therapy reduces frequency and severity of Raynaud attacks. The effect is most pronounced in patients with signs of decreased threshold for vasospasm and less effective in patients with delayed hyperemia. (J Rheumatol 2004;31:2408-12) Key Indexing Terms:
RAYNAUD'S DISEASE
From the Department of Angiology, Hanusch Hospital, Vienna; and the Institute of Environmental Health, Medical University of Vienna, Vienna, Austria. M. Hirschl, MD, Associate Professor; R. Katzenschlager, MD, Associate Professor; C. Francesconi, MD, Department of Angiology, Hanusch Hospital; M. Kundi, PhD, Professor, Institute of Environmental Health, Medical University of Vienna. Address reprint requests to Dr. M. Hirschl, Department of Angiology, Hanuschkrankenhaus, Heinrich Collinstrasse 30, A-1140 Vienna, Austria. E-mail: Mirko.Hirschl@wgkk.sozvers.at Submitted December 1, 2003; revision accepted July 7, 2004. |