RESEARCH - The efficacy of complementary and alternative medicine in the treatment of Raynaud's phenomenon

[Guest guest]

Rheumatology Advance Access originally published online on May 11, 2009

Rheumatology 2009 48(7):791-795; doi:10.1093/rheumatology/kep039

The efficacy of complementary and alternative medicine in the

treatment of Raynaud's phenomenon: a literature review and

meta-analysis

Deanne Malenfant1, Catton2 and Janet E. Pope1,3

1Schulich School of Medicine and Dentistry, University of Western

Ontario, London, Ontario,2Department of Medicine, University of

Ottawa, Ottawa and 3Department of Medicine, St ph's Health Care,

London, Ontario, Canada.

Abstract

Objective. Conventional treatment for RP is limited due to side

effects, and complementary and alternative medicines (CAM) are widely

used by the population. Our objective was to find an effective and

well-tolerated CAM for the treatment of RP.

Methods. Using MEDLINE, EMBASE and AMED, 20 randomized controlled

trials (RCTs) were found and divided into nine treatment

subcategories: acupuncture (n = 2 trials), anti-oxidants (n = 2),

biofeedback (n = 5), essential fatty acids (n = 3), Ginkgo biloba (n =

1), L-arginine (n = 2), laser (n = 3), glucosaminoglycans (n = 1) and

therapeutic gloves (n = 1). Trials in each subcategory were

meta-analysed together.

Results. Several categories did not have enough trials to do a

meta-analysis and most trials were negative, of poor quality and done

prior to 1990. Biofeedback was negative for a change in frequency,

duration and severity of RP attacks, and actually favoured control

(sham biofeedback; P < 0.02). The therapeutic glove favoured active

treatment (P < 0.00001). Laser resulted in one less RP attack on

average over 2 weeks vs sham [weighted mean difference (WMD) 1.18; 95%

CI 1.06, 1.29], and a change in severity of attacks (WMD 1.98; 95% CI

1.57, 2.39; P < 0.05). No significant differences were found in the

nutritional supplements that were studied.

Conclusions. There is a need for well-designed trials of CAM in RP.

The literature is inconclusive except that biofeedback does not work

for RP, therapeutic gloves may improve RP (but results may not be

generalizable due to single trial site and no intent-to-treat

analysis) and laser may be effective but the improvement may not be

clinically relevant.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/48/7/791?etoc

Not an MD