460 Calcium channel blockers minimally effective for Raynaud’s phenomenon

July 04, 2015

written by Brian R McAvoy

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.

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.

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.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.