title: A Randomized Controlled Trial of Acupressure for the Treatment of Raynaud's Phenomenon: The difficulty of conducting a trial in Raynaud's phenomenon.
abstract: OBJECTIVE
  To examine the effect of acupressure on Raynaud's phenomenon (RP) in a randomized controlled clinical trial (RCT) and to evaluate the difficulties of conducting a RP RCT.
  
  
  METHODS
  A pilot single center RCT of acupressure vs. targeted patient education was conducted for the treatment of RP. Patients with either primary (N = 15) or secondary (N = 8) RP were randomized in an 8-week study. The primary endpoints included a decrease in the frequency and duration of RP. Secondary endpoints included several serum biomarkers including endothelial dysfunction, Raynaud's attack symptoms, Raynaud's Condition Score, and patient and physician global assessments of RP. Primary data analysis was conducted using the last observation carried forward and t-tests or a Wilcoxon rank test was used to compare the two groups.
  
  
  RESULTS
  23 patients were randomized and 7 discontinued prematurely. 78% of patients were female, 96% were Caucasian, and the mean age was 49.8 (SD=16) years. No statistically significant differences were detected between the acupressure vs. education groups in primary and secondary outcomes (p> 0.05). Frequency of attacks decreased by 6.7 attacks (SD=8.8) in the acupressure group vs. 7.2 (SD=12.8) in the education group (p=0.96), and the duration of attacks decreased by 11.4 (SD=19.9) minutes in the acupressure group vs. an increase of 0.8 minutes (SD=11.2) in the education group (p=0.14). There were no adverse events noted in the RCT.
  
  
  CONCLUSIONS
  This pilot study does not support efficacy of acupressure for RP.
authors.affiliation: University of Michigan Scleroderma Program.
authors.forename: Heather
authors.initials: H
authors.lastname: Gladue
authors.affiliation: University of Michigan Department of Biostatistics.
authors.forename: Veronica
authors.initials: V
authors.lastname: Berrocal
authors.affiliation: University of Michigan Department of Anesthesia.
authors.forename: Richard
authors.initials: R
authors.lastname: Harris
authors.affiliation: University of Michigan Scleroderma Program; Division of Rheumatology, University of Michigan Medical School.
authors.forename: Pei-Suen
authors.initials: PS
authors.lastname: Tsou
authors.affiliation: Division of Rheumatology, University of Michigan Medical School.
authors.forename: Gautam
authors.initials: G
authors.lastname: Edhayan
authors.affiliation: Division of Rheumatology, University of Michigan Medical School.
authors.forename: Ray
authors.initials: R
authors.lastname: Ohara
authors.affiliation: University of Michigan Scleroderma Program; Division of Rheumatology, University of Michigan Medical School.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Khanna
keywords: Acupressure; Clinical Trial; Composite Index; Raynaud's Phenomenon