title: Effectiveness of interventions for secondary Raynaud's phenomenon: a systematic review.
abstract: OBJECTIVE
  To present an evidence-based overview of the effectiveness of (non)surgical symptomatic interventions to treat secondary Raynaud's phenomenon (RP).
  
  
  METHODS
  The Cochrane Library, PubMed, Embase, PEDro, and CINAHL were searched for relevant systematic reviews and randomized controlled trials (RCTs).
  
  
  METHODS
  Two reviewers independently applied the inclusion criteria to select potential studies.
  
  
  METHODS
  Two reviewers independently extracted data and assessed the methodologic quality.
  
  
  RESULTS
  If pooling of data was not possible, a best-evidence synthesis was used to summarize the results. Of the 5 reviews and 19 RCTs included, 1 RCT studied acupuncture and another RCT reported on percutaneous radiofrequency thoracic sympathectomy. All others concentrated on the effectiveness of drugs (oral or intravenous [IV]). It appeared that calcium channel blockers significantly reduce the frequency and severity of Raynaud attacks, and are therefore effective in the treatment of secondary RP. Iloprost (oral and IV) was also found to be effective. Limited evidence was found for atorvastatin. For other traditional and more recently discovered interventions, no clear favorable effects were found.
  
  
  CONCLUSIONS
  This review shows that there is clear evidence in favor of calcium channel blockers and iloprost (oral and IV) to treat secondary RP. For all other interventions, only limited, conflicting, or no evidence was found. More high-quality, well-designed RCTs are needed in this field, especially for new interventions based on recent knowledge about the pathophysiology of secondary RP.
authors.affiliation: Department of General Practice, Erasmus MC - University Medical Center Rotterdam, the Netherlands. b.huisstede@erasmusmc.nl
authors.forename: Bionka M
authors.initials: BM
authors.lastname: Huisstede
authors.forename: Peter
authors.initials: P
authors.lastname: Hoogvliet
authors.forename: Winifred D
authors.initials: WD
authors.lastname: Paulis
authors.forename: Marienke
authors.initials: M
authors.lastname: van Middelkoop
authors.forename: Michael
authors.initials: M
authors.lastname: Hausman
authors.forename: J Henk
authors.initials: JH
authors.lastname: Coert
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
mesh_terms: D015670:Acupuncture Therapy; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use; D000078702:Radiofrequency Therapy; D016032:Randomized Controlled Trials as Topic; D011928:Raynaud Disease / Q000188:drug therapy / Q000628:therapy*; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D002121:Calcium Channel Blockers; D014665:Vasodilator Agents; D016285:Iloprost