The efficacy of complementary and alternative medicine in the treatment of Raynaud's phenomenon: a literature review and meta-analysis

Malenfant, Déanne; Catton, Michelle; Pope, Janet

doi:10.1093/rheumatology/kep039

Cited by 55 publications

(38 citation statements)

References 17 publications

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“…In a 2009 literature review, Malenfant et al identifi ed a total of 20 RCTs investigating various treatment strategies, e.g., biofeedback (n = 5), acupuncture (n = 2), anti-oxidants (n = 2), essential fatty acids (n = 3), Ginkgo biloba (n = 1), Larginine (n = 2), laser (n = 3), glucosaminoglycans (n = 1) and the use of therapeutic gloves (n = 1) [9]. Whereas gloves signifi cantly reduced the frequency, duration and severity of RP attacks [10], no signifi cant diff erences were observed with the nutritional supplements that were studied.…”

Section: Non-pharmacologic Approachmentioning

confidence: 99%

“…In three studies, low level laser therapy reduced the frequency and severity of RP attacks. The overall quality of the studies included in this review was deemed to be low to moderate, so defi nitive conclusions could not be drawn [9].…”

Section: Non-pharmacologic Approachmentioning

confidence: 99%

“…In RAPIDS-2, 188 SSc patients with digital ulcers at trial entry demonstrated a signifi cant 30 % reduction in new digital ulcers compared with placebo (1.9 % vs. 2.7 %), but again, no diff erences in the healing rate of the cardinal ulcer or RP attacks were observed [60]. In a recently published study, Cutolo et al demonstrated the benefi cial eff ects of bosentan in addition to cyclic intravenous iloprost in patients with severe SSc-related RP [ ESM 2,9]. The authors observed signifi cant increases in fi ngertip blood perfusion, capillary dilation and the number of capillaries.…”

Section: Vasodilator Therapymentioning

confidence: 99%

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Raynaud’s phenomenon and digital ischaemia - pharmacologic approach and alternative treatment options

Linnemann

Erbe

2016

Vasa

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Summary:The primary goal of therapy is to reduce the frequency and intensity of Raynaud's attacks and to minimize the related morbidity rather than to cure the underlying condition. Treatment strategies depend on whether Raynaud's phenomenon (RP) is primary or secondary. All patients should be instructed about general measures to maintain body warmth and to avoid triggers of RP attacks. Pharmacologic intervention can be useful for patients with severe and frequent RP episodes that impair the patient's quality of life. Calcium channel blockers are currently the most prescribed and studied medications for this purpose. There has been limited evidence for the effi cacy of alpha-1-adrenergic receptor antagonists, angiotensin receptor blockers, topical nitrates or fl uoxetine to treat RP. The intravenously administered prostacyclin analogue iloprost can reduce the frequency and severity of RP attacks and is considered a second-line therapy in patients with markedly impaired quality of life, critical digital ischaemia and skin ulcers who are at risk for substantial tissue loss and amputation. Phosphodiesterase inhibitors (e.g., sildenafi l) can also improve RP symptoms and ulcer healing whereas endothelin-1 receptor antagonists (e.g., bosentan) are mainly considered treatment options in secondary prevention for patients with digital skin ulcers related to systemic sclerosis. However, their use in clinical practice has been limited by their high cost. Antiplatelet therapy with low-dose aspirin is recommended for all patients who suffer from secondary RP due to ischaemia caused by structural vessel damage. Anticoagulant therapy can be considered during the acute phase of digital ischaemia in patients with suspected vascular occlusive disease attributed to the occurrence of new thromboses. In patients with critical digital ischaemia, consideration should be given to hospitalisation, optimisation of medical treatment in accordance with the underlying disease and evaluation for a secondary, possibly reversible process that is causing or aggravating the clinical symptoms.

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Section: Non-pharmacologic Approachmentioning

confidence: 99%

Section: Non-pharmacologic Approachmentioning

confidence: 99%

Section: Vasodilator Therapymentioning

confidence: 99%

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Raynaud’s phenomenon and digital ischaemia - pharmacologic approach and alternative treatment options

Linnemann

Erbe

2016

Vasa

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“…sruk.co.uk). Although some patients also consider a number of complementary therapies, 15 there is no strong evidence base to recommend these interventions at present.…”

Section: First and Second-line Optionsmentioning

confidence: 99%

Assessment and management of Raynaud's phenomenon

Hughes¹,

Herrick²

2017

Prescriber

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“…In skin lesions the only tools available before starting an immunosuppressive therapy are patient education and vasodilator drugs, if tolerated. 2 Alternative medicine did not show clear results on microcirculation, Raynaud phenomenon, pain, 3 and consequently on quality of life.…”

Section: Introductionmentioning

confidence: 95%

Treatment of digital ulcers with oxygen-ozone therapy in a patient with systemic sclerosis

Riva¹,

Balestra²,

Giannini³

et al. 2017

Ozone Ther

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Patients with systemic sclerosis often suffer from Raynaud's phenomenon and in the most severe cases it causes digital ulceration and difficult healing. Treatment for these complications are not always resolutive and sometimes not well tolerated.The O2O3 therapy is a gas mixture that has several demonstrated effects including antiseptic, painkiller, microcirculation vasodilator, oxygen metabolism regulator and immunomodulation, and it can be personalised, administered to individual patient requirements.We decided to offer this treatment to our patients after the failure of traditional drugs and surgery without influencing the therapeutic program. The results obtained are interesting, and though more studies are needed to better understand the exact mechanism of action of O2O3 therapy, we believe that in the meantime, this therapy should be considered as treatment for the most severe cases.

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The efficacy of complementary and alternative medicine in the treatment of Raynaud's phenomenon: a literature review and meta-analysis

Cited by 55 publications

References 17 publications

Raynaud’s phenomenon and digital ischaemia - pharmacologic approach and alternative treatment options

Raynaud’s phenomenon and digital ischaemia - pharmacologic approach and alternative treatment options

Assessment and management of Raynaud's phenomenon

Treatment of digital ulcers with oxygen-ozone therapy in a patient with systemic sclerosis

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