Effects of locally applied water-filtered infrared a irradiation adjunctive to iloprost and carbon dioxide hand baths in patients with systemic sclerosis and severe Raynaud's phenomenon - a randomized controlled trial.
Nils Schulz, Priyanka Boettger, Joachim Bär et al.
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In 30 seconds
This randomized controlled trial assessed whether water-filtered infrared-A (wIRA) added to iloprost and carbon dioxide hand baths improved severe Raynaud’s phenomenon in patients with systemic sclerosis. Of 46 randomized patients, 38 completed the study. After treatment, pain favored adjunctive wIRA, with an adjusted mean difference of -14.7 mm (95% CI [-28.8;-0.7], p = 0.041). Raynaud’s duration also improved more with wIRA, whereas frequency, intensity, function, and measured biomarkers did not differ significantly. No adverse events occurred; the authors describe the benefits as modest and short-term.
Key findings
- Pain favored wIRA, with an adjusted mean difference of -14.7 mm (95% CI [-28.8;-0.7], p = 0.041).
- Raynaud’s duration improved more with wIRA at day 23 (β = -3.8, 95% CI [-7.4;-0.2], p = 0.041).
- No significant between-group differences were found for Raynaud’s frequency or intensity, HAQ, IL-6, or VEGF (all p > 0.05).
- No adverse events occurred; 38 of 46 randomized patients completed the study.
Why it matters
Severe Raynaud’s phenomenon in systemic sclerosis can cause substantial pain and carries a risk of digital ulcers. This trial suggests that adding local wIRA to iloprost and carbon dioxide hand baths may provide short-term improvement in pain and episode duration, while other measured outcomes were unchanged. The findings help inform evaluation of adjunctive hyperthermic approaches but remain exploratory.
What to keep in mind
Only 38 of 46 randomized patients completed the study, and the authors characterize the effects as exploratory and short-term, requiring confirmation in larger controlled trials.