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. 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.