Vitamin B3 may improve blood vessels in scleroderma-related Raynaud’s
Study says changes did not translate into meaningful symptom reduction
Written by |
Oral treatment with vitamin B3 for a couple of weeks may reduce abnormalities in tiny blood vessels of people with scleroderma who have Raynaud’s phenomenon, a small study suggests.
After two weeks of supplementation, participants showed more normal and fewer giant blood vessels under the fingernails, although these changes did not translate into meaningful symptom reduction or improved quality of life.
According to researchers, “the more limited subjective response in scleroderma-related [Raynaud’s] may reflect reduced vasodilatory [blood vessel widening] responsiveness in the context of established structural vascular disease.”
The study, “Vitamin B3 (Nicotinamide) Supplementation in Primary and Scleroderma-Related Raynaud Phenomenon,” was published in ACR Open Rheumatology.
Raynaud’s is common in scleroderma patients
Scleroderma is marked by thick and hardened skin due to the buildup of scar tissue, which may also cause damage to internal organs. Raynaud’s phenomenon, characterized by numb, prickly, and frigid fingers and toes in response to cold temperatures or stress, is common in people with scleroderma.
In this study, researchers in Australia investigated whether vitamin B3 (nicotinamide), a molecule with blood vessel widening properties, could be a safe and beneficial treatment for scleroderma-related Raynaud’s phenomenon. The study also included people with primary Raynaud’s, which occurs without an underlying disease.
A total of 38 participants were enrolled at centers in Australia, 18 with scleroderma-related and 20 with primary Raynaud’s. Among those with scleroderma, the mean age was 57.4 years, and 78% were women. Two-thirds had limited scleroderma, while six had the more severe diffuse scleroderma.
The six-week study included two weeks of baseline (starting) assessments, two weeks of vitamin B3 supplementation at 500 mg twice daily, and a two-week washout period after treatment. Participants recorded their Raynaud’s symptoms daily using the Raynaud Condition Score, as well as their ambient temperature and medication changes. Adherence to vitamin B3 was high, with participants taking 98.7% of the prescribed doses.
Vitamin B3 was generally well tolerated. One participant with CREST syndrome, a form of limited SSc, discontinued treatment. No significant changes in systolic blood pressure were observed.
Appearance of small blood vessels improved in scleroderma group
At the start of the study, half of the participants with scleroderma had an active scleroderma pattern on nailfold videocapillaroscopy (NVC), a noninvasive test that examines the tiny blood vessels beneath the fingernails.
After two weeks of vitamin B3, the appearance of these small blood vessels improved significantly. Participants with scleroderma had a higher proportion of normal capillaries and fewer giant capillaries, suggesting an improvement in some of the vascular abnormalities associated with Raynaud’s. After the two-week washout period, three participants still had an improved NVC pattern compared with baseline, while most showed no change.
However, the proportion of participants reaching the study’s predefined thresholds for an acceptable level of Raynaud’s symptoms or severity increased only slightly after vitamin B3, and the changes were not considered clinically meaningful. By contrast, a significantly higher proportion of people with primary Raynaud’s reached an acceptable level of symptoms after taking the vitamin B3 supplements.
The researchers cautioned that the NVC findings should not be interpreted as evidence that vitamin B3 reversed scleroderma-related blood vessel damage. Instead, the changes may reflect improvements in blood flow or capillary recruitment (when more capillaries open up).
Overall, the findings suggest that short-term vitamin B3 supplementation may improve blood vessel abnormalities associated with scleroderma-related Raynaud’s, although the clinical significance of these changes remains unclear.
The researchers noted that larger studies “with longer duration and/or higher dosing — particularly in scleroderma-related [Raynaud’s] — are required to determine whether these early functional changes translate into meaningful and sustained clinical or structural vascular outcomes.”
Leave a comment
Fill in the required fields to post. Your email address will not be published.