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Raynaud PhenomenonNCT03869008

Potential Benefit for Non Invasive Vagus Nerve Stimulation Using GammaCore in the Treatment of Raynaud's Phenomena.

A study testing gammaCore Sapphire in people with Raynaud Phenomenon and Primary Raynaud Phenomenon, run by University of Toledo Health Science Campus at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Raynaud's phenomenon (RP) is a common vascular disorder that affects approximately 10% of the general population. RP is associated with significant morbidity that may include loss of the digits due to repeated episodes of vasospasm of the digital arteries in addition to significant impairment of quality of life. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
gammaCore Sapphire
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
6 participants
Where
1 siteUnited States
Study dates
30 Apr 2019to 27 Feb 2020
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Clinical Diagnosis of Primary Raynaud's Phenomenon

Who cannot join

  • Less than 18 years of age
  • Pregnant women
  • Current smokers
  • Have Digital ulcers
  • Diagnosed Pulmonary hypertension
  • Currently on vasodilators (i.e. Phosphodiesterase type 5 inhibitors, prostacyclin, nitroglycerine, or other nitric oxide derivatives)
  • Currently on Calcium Channel Blockers

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Unversity of Toledo Medical Center

    Toledo, Ohio, 43614

Other trials in United States

About this study

Official title: Potential Benefit for Non Invasive Vagus Nerve Stimulation (nVNS) Using GammaCore in the Treatment of Raynaud's Phenomena.

Raynaud's phenomenon (RP) is a common vascular disorder that affects approximately 10% of the general population. RP is associated with significant morbidity that may include loss of the digits due to repeated episodes of vasospasm of the digital arteries in addition to significant impairment of quality of life. It is well known that cold exposure precipitates episodes of RP, but the mechanism for cold sensitivity is not known, and treatment of RP is not satisfactory to the patients and their physicians.

The goal in this study is to test the possibility that non invasive vagus nerve stimulation (nVNS) with gammaCore which is already approved by the FDA for headaches and migraines may be an effective and well tolerated therapy for Raynaud's Phenomenon.

Read the detailed description

Raynaud's phenomenon (RP) is a common vascular disorder that that affects approximately 10% of the general population. RP causes some areas of the body (i.e. fingers and toes) to feel cold and numb in response to cold exposure or emotional stress. Raynaud's phenomenon is characterized by reversible vasospasm of the fingers and toes. This reversible narrowing of the small arteries induces episodes of color changes of the fingers and toes. During an attack of Raynaud's, affected areas of the skin usually first turn white, then they often turn blue and feel cold and numb (pins and needles). As the fingers warm and circulation improves the affected areas may turn red, throb and tingle.

Moreover, Raynaud's phenomenon can be associated with significant morbidity that may include ulceration of fingers and loss of the fingers and toes due to repeated episodes of reversible narrowing of arteries supplying blood to the finger and toes. It is well known that cold exposure leads to episodes of RP, but the mechanism for cold sensitivity is not known, and treatment of RP is not satisfactory to the patients and their physicians.

Raynaud's phenomenon is classified as Primary Raynaud's phenomenon (PRP) in the absence of other vascular or connective tissue disease. Raynaud's phenomenon is classified as Secondary Raynaud's phenomenon (SRP) if it is associated with connective tissue disease, like systemic sclerosis (SSc, Scleroderma).

Treatment of Raynaud's phenomenon is not satisfactory in general, as current therapy employing calcium channel blockers and other vasodilators are frequently ineffective or not well tolerated, due to significant side effects.

Noninvasive vagus nerve stimulation (nVNS) is currently FDA approved for therapeutic uses in patient ages 12 and above to treat cluster and migraine headaches. Recent studies have shown that vagal nerve stimulation has vasodilatory and anti-inflammatory properties which has led to more preclinical research examining vagus nerve stimulation as treatment for a wider range of inflammatory and autoimmune disorders. Vagus nerve stimulation has shown promising results in treating chronic inflammatory disorders such as sepsis, lung injury, rheumatoid arthritis, and diabetes. Although there are no direct data to demonstrate vagus nerve stimulation's effect in Raynaud's phenomenon, the investigators believe that VNS's success in treating headache and migraine attacks indirectly support its use in Raynaud's phenomenon by its direct effect on vasospasms (narrowing of blood vessels). In fact migraine has been found as a risk factor for the development of Raynaud's phenomenon further supports this notion.

GammaCore is a safe and effective non-drug treatment approved for treating cluster and migraine headaches. It is a patented device that activates the vagus nerve with gentle electrical stimulation. The vagus nerve is an important highway of communication between the brain and many parts of the body, it plays an important role in regulating pain. Noninvasive vagus nerve stimulation with GammaCore is believed to help block the pain signals that cause migraines and cluster headaches. Unlike traditional vagus nerve stimulation therapies, gammaGore stimulates the vagus nerve through the skin at the side of the neck without the need for surgery. This non-invasive method avoids many side effects and inconveniences associated with injectable, inhaled or pill-based medication.

The investigators' goal is to test the possibility that noninvasive vagus nerve stimulation using gammaCore may be an effective and well tolerated therapy for Raynaud's phenomenon. The investigators aim to gain a fundamental understanding of the role of noninvasive vagus nerve stimulation as a potential therapy for Raynaud's phenomenon, a truly unmet medical need.

Being tested
gammaCore Sapphire, Sham Device
Medical subject headings
Raynaud Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • gammaCore SapphireDevice

    gammaCore SapphireTM (non-invasive vagus nerve stimulator) is intended to provide non-invasive vagus nerve stimulation (nVNS) on the side of the neck. gammaCore provides a mild electrical stimulation to the vagus nerve, which runs through the neck and carries information to the central nervous system.

    Subjects will be instructed to use the gammaCore Sapphire to stimulate 2 minutes on each side of the neck, twice a day, every day. The subject controls the intensity level of the electrical stimulation.

  • Sham DeviceDevice

    The Sham device delivers no electrical stimulations but subjects randomized to the Sham device will received the same instructions to use the Sham device to stimulate 2 minutes on each side of the neck, twice a day, every day for the first 4 weeks after randomization.

Study groups in NCT03869008
Study groupRoleWhat they receive
Sham Device GroupSham comparator15 patients will be randomized to the Sham device for the first half of the treatment window then switch to the gammaCore Sapphire device (study device) for the rest of the study. The Sham device will look exactly like the gammaCore Sapphire device but will not deliver non invasive vagus nerve stimulation.
Receives: Device: gammaCore Sapphire; Device: Sham Device
gammaCore Sapphire (Study Device) GroupExperimental15 patients will be randomized to the gammaCore Sapphire device for the full length of the treatment window.
Receives: Device: gammaCore Sapphire

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Temperature in 4 Digits

    Temperature measured by infrared thermography

    Measured: Visit 1 which is Week -4 (Screening) to Visit 2 which is Week 0 (Randomization)

Secondary outcomes (1)
  1. Condition Scores

    The Raynaud's Condition Score is on a scale of 0 to 10 with "0" being no difficulty, "10" being extreme difficulty.

    Measured: n/a - No data was collected.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Mar 2019
  2. Study start30 Apr 2019
  3. Primary completion27 Feb 2020
  4. Study completion27 Feb 2020

Why it stopped: Funding is no longer available

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
At randomization subjects are randomized to 2 groups, the Experimental group and the Sham group. The Experimental group will use the study device from randomization to the end of the study. The Sham group will use the Sham device for 4 weeks after randomization then be switched to the study device for the rest of the study.
Masking
Single blind
Who is masked
Participant
Enrolment
6 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03869008
Sponsor's protocol ID
gammaCore RP
Status last verified
May 2025
First submitted
20 Feb 2019
Last updated
15 Jul 2025
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Undecided

Publications

  • Garner R, Kumari R, Lanyon P, Doherty M, Zhang W. Prevalence, risk factors and associations of primary Raynaud's phenomenon: systematic review and meta-analysis of observational studies. BMJ Open. 2015 Mar 16;5(3):e006389. doi: 10.1136/bmjopen-2014-006389.

    PubMed 25776043
  • Brand FN, Larson MG, Kannel WB, McGuirk JM. The occurrence of Raynaud's phenomenon in a general population: the Framingham Study. Vasc Med. 1997 Nov;2(4):296-301. doi: 10.1177/1358863X9700200404.

    PubMed 9575602
  • Merkel PA, Herlyn K, Martin RW, Anderson JJ, Mayes MD, Bell P, Korn JH, Simms RW, Csuka ME, Medsger TA Jr, Rothfield NF, Ellman MH, Collier DH, Weinstein A, Furst DE, Jimenez SA, White B, Seibold JR, Wigley FM; Scleroderma Clinical Trials Consortium. Measuring disease activity and functional status in patients with scleroderma and Raynaud's phenomenon. Arthritis Rheum. 2002 Sep;46(9):2410-20. doi: 10.1002/art.10486.

    PubMed 12355489
  • Matucci-Cerinic M, Kahaleh B, Wigley FM. Review: evidence that systemic sclerosis is a vascular disease. Arthritis Rheum. 2013 Aug;65(8):1953-62. doi: 10.1002/art.37988. No abstract available.

    PubMed 23666787
  • Ennis H, Anderson ME, Wilkinson J, Herrick AL. Calcium channel blockers for primary Raynaud's phenomenon. Cochrane Database Syst Rev. 2014 Jan 30;(1):CD002069. doi: 10.1002/14651858.CD002069.pub4.

    PubMed 24482037
  • Coleiro B, Marshall SE, Denton CP, Howell K, Blann A, Welsh KI, Black CM. Treatment of Raynaud's phenomenon with the selective serotonin reuptake inhibitor fluoxetine. Rheumatology (Oxford). 2001 Sep;40(9):1038-43. doi: 10.1093/rheumatology/40.9.1038.

    PubMed 11561116
  • Pauling JD, Shipley JA, Harris ND, McHugh NJ. Use of infrared thermography as an endpoint in therapeutic trials of Raynaud's phenomenon and systemic sclerosis. Clin Exp Rheumatol. 2012 Mar-Apr;30(2 Suppl 71):S103-15. Epub 2012 May 30.

    PubMed 22691218
  • James PB. Cooling patterns in Raynaud's phenomenon and allied peripheral vascular disorders. Br J Surg. 1968 Nov;55(11):860. No abstract available.

    PubMed 5686991
  • Zaproudina N, Varmavuo V, Airaksinen O, Narhi M. Reproducibility of infrared thermography measurements in healthy individuals. Physiol Meas. 2008 Apr;29(4):515-24. doi: 10.1088/0967-3334/29/4/007. Epub 2008 Apr 9.

    PubMed 18401069
  • Pauling JD, Shipley JA, Raper S, Watson ML, Ward SG, Harris ND, McHugh NJ. Comparison of infrared thermography and laser speckle contrast imaging for the dynamic assessment of digital microvascular function. Microvasc Res. 2012 Mar;83(2):162-7. doi: 10.1016/j.mvr.2011.06.012. Epub 2011 Jul 1.

    PubMed 21763703
  • Schlager O, Gschwandtner ME, Herberg K, Frohner T, Schillinger M, Koppensteiner R, Mlekusch W. Correlation of infrared thermography and skin perfusion in Raynaud patients and in healthy controls. Microvasc Res. 2010 Jul;80(1):54-7. doi: 10.1016/j.mvr.2010.01.010. Epub 2010 Feb 6.

    PubMed 20144625
  • Johnson RL, Wilson CG. A review of vagus nerve stimulation as a therapeutic intervention. J Inflamm Res. 2018 May 16;11:203-213. doi: 10.2147/JIR.S163248. eCollection 2018.

    PubMed 29844694
  • Silberstein SD, Calhoun AH, Treppendahl C, Dodick DW, Rapoport AM, Mamidi A, Vargas P, Ebert TH, Tepper SJ. The emerging role of gammaCore(R) in the management of cluster headache: expert panel recommendations. Am J Manag Care. 2017 Nov;23(17 Suppl):S326-S333.

    PubMed 29144718

Questions about this trial

What is this clinical trial studying?

A study testing gammaCore Sapphire in people with Raynaud Phenomenon and Primary Raynaud Phenomenon, run by University of Toledo Health Science Campus at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 15 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 Jul 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Temperature in 4 Digits (time frame: Visit 1 which is Week -4 (Screening) to Visit 2 which is Week 0 (Randomization)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03869008, which also lists 13 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jul 2025.

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