Clinical question
How effective are calcium channel blockers for primary Raynaud’s phenomenon?
Bottom line
Treatment with oral calcium channel blockers (CCBs) was found to be minimally effective in primary Raynaud's phenomenon, reducing the frequency of attacks by around 1.7 attacks per person per week. In the largest trial, participants had an average of 4 attacks per week in cold weather without the use of medication. There were no effects on severity scores or physiological measurements, such as finger blood flow. Treatment with CCBs was associated with a number of adverse events, including headaches, flushing and ankle oedema.
Caveat
This effect size was small, although it might have been greater with a longer duration of treatment. The results were limited by small sample sizes and variable overall data quality.
Context
Primary Raynaud's phenomenon is extremely common (especially in women), with one UK study suggesting that over 15% of the population are affected. CCBs are the most commonly prescribed drugs for this condition.
Cochrane Systematic Review
Ennis H et al. Calcium channel blockers for primary Raynaud’s phenomenon. Cochrane Reviews, 2014, Issue 1. Art. No.: CD002069.DOI: 10.1002/14651858. CD002069.pub4. This review contains 7 studies involving 296 participants.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
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