Treatment Of Primary Raynaud's Phenomenon Research Articles

Effectiveness of Chinese herbal medicine for primary Raynaud's phenomenon: a systematic review and Meta-analysis of randomized controlled trials.

To evaluate the effectiveness of Chinese herbal medicine for primary Raynaud's phenomenon (PRP). The Cochrane Central Register of Controlled Trials, PubMed, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database were searched up to February 13, 2018. Randomized controlled trials (RCTs) on treatment of PRP with Chinese herbal medicine compared with placebo, blank control, lifestyle changes, or calcium antagonists were identified and reviewed. The quality of included trials was assessed using a risk of bias tool. Eight RCTs involving 674 participants were included. The methodological quality of the included trials was generally poor. Meta-analysis of two trials showed that Buyang Huanwu Tang plus Danggui Sini Tang produced greater improvement in global symptoms than nifedipine. One trial showed that Danggui Sini Tang and a self-composed Chinese herbal medicine decoction, respectively, produced greater improvement in global symptoms than nifedipine alone. In one trial, modified Danggui Sini Tang showed greater improvement in global symptoms and arterial peak systolic velocity compared with nifedipine. One trial showed that Jiejing Tongmi Tang produced greater improvement in global symptoms, plasma endothelin, and plasma nitric oxide than cinepazide maleate injection. However, Jiejing Tongmi Tang did not produce a significant difference in skin temperature and peripheral artery blood stream drawing after cold pressor testing compared with cinepazide maleate injection. None of the trials reported frequency of attacks, duration of attacks, participant preference scores, or adverse events. Chinese herbal medicine may have a positive effective on PRP. However, owing to weak methodology, the benefits of Chinese herbal medicine for PRP are inconclusive. More rigorously designed studies are needed to confirm these findings.

No Significant Effect of Ginkgo Biloba Special Extract EGb 761 in the Treatment of Primary Raynaud Phenomenon

Medicinal treatment of vasospastic Raynaud phenomenon is limited to primarily vasodilator medicines. To explore the possible beneficial effects and tolerability of 120 mg two times a day of Ginkgo Biloba special extract EGb 761 in patients suffering from Raynaud disease (RD) (primary Raynaud phenomenon). In a placebo-controlled, double-blind, pilot study, 41 patients with RD were randomized to either the active treatment group (EGb 761, n = 21) or placebo group for 10 weeks, after an initial 2-week run-in phase. The primary efficacy variables were self-reported changes of the frequency, duration, and severity of vasospastic attacks between the placebo-controlled run-in phase and the end of the study. Most of the patients were female, and both groups were perfectly matched with respect to demographic characteristics. The frequency of daily attacks reduced from 3.6 ± 2.3 to 2.4 ± 2.6 (-33%) in the EGb 761 group and from 2.9 ± 2.0 to 2.0 ± 1.8 (-31%) in the placebo group with no significant difference according to the ordinary least squares test (P = 0.3564). Furthermore, no significant differences were found with respect to the duration and severity of vasospastic attacks between the EGb 761 and placebo groups (P = 0.4392 and P = 0.7187, respectively). In all, 17 adverse events (AEs) were reported, 6 AEs from 5 patients in the EGb 761 group and 11 AEs from 8 patients in the placebo group. Serious AEs did not occur. EGb 761 treatment showed an excellent safety profile in patients with RD but could not demonstrate a statistically significant reduction in clinically relevant symptoms compared with placebo.

Controlled multicenter double-blind trial of nicardipine in the treatment of primary Raynaud phenomenon

A total of 69 patients with primary Raynaud phenomenon were included in a multicenter, randomized, double-blind, crossover, placebo-controlled trial to assess the efficacy of nicardipine, a new calcium channel blocker. The trial data were combined with a meteorological survey. Nicardipine significantly ( p = 0.02) reduced the number of crises of Raynaud phenomenon but had no significant effect on the intensity of the crises. Mean overall improvement, assessed on a linear visual analog scale, was 21% ( p = 0.018), but results for the cold-reactive hyperemia test were not significantly altered after nicardipine treatment. All side effects were mild, and their frequency only differed significantly ( p < 0.05) from that of placebo for edema and headache.