Botulinum Toxin A in the treatment of frostbite sequelae - results from a blinded, early-phase, comparative trial

• Published in: International journal of circumpolar health Vol. 82; no. 1; p. 2189556
• Main Authors: Norheim, Arne Johan, Borud, Einar, Mercer, James Brian, de Weerd, Louis, Weiss, Thomas, Wilsgaard, Tom
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01.12.2023; Taylor & Francis Ltd; Taylor & Francis Group
• Subjects: Arctic Military Conference in Cold Weather Medicine; Botulinum toxin; Botulinum Toxins, Type A - adverse effects; BTX; freezing cold injury; Frostbite; Frostbite - drug therapy; Humans; military; Pilot Projects; quantitative sensory test; Research Design; Rewarming; sequelae; thermography; Treatment Outcome; botulinum toxin; sequelae; Frostbite; BTX; military; quantitative sensory test; thermography; freezing cold injury
• ISSN: 2242-3982; 1239-9736; 2242-3982
• DOI: 10.1080/22423982.2023.2189556

Introduction: Freezing Cold Injuries (FCI) have been associated with long-term sequelae including vasospasm. The aims of the pilot study are to explore the research methodology and investigate the tolerability and safety of treatment with Botulinum Toxin-A (BTX-A) in FCI Sequelae. Methodology: This pilot study tests the logistics, the treatment setting and the follow-up procedure in an early-phase, double-blinded, randomized, controlled trial study-design. The variables in the study were subjective symptoms, peripheral micro-vascularization/rewarming, somatosensory responsiveness, and generic measure of health status. Results: No major challenges or difficulties were noticed according to the protocol or the study methodology. The monitoring of tolerability and safety of treatment with BTX-A did not reveal any major unwanted and/or adverse reactions among the patients in the pilot study and no challenges occurred during data collection of endpoints. The study revealed an inaccuracy of the 2nd degree FCI diagnosis and uncover a need for relevant and sufficient clinical information for FCI classification. Conclusions: This pilot study showed the study methodology with minor adjustments is feasible in a future full-scale clinical trial. The recruitment process needs to be more refined to ensure that the eligible study participants are a homogenous group of FCI patients.