RESEARCH - A pilot study of acupuncture as adjunctive treatment of RA

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Clin Rheumatol. 2007 Nov 8 [Epub ahead of print]

A pilot study of acupuncture as adjunctive treatment of rheumatoid arthritis.

Zanette SD, Born IG, Brenol JC, Xavier RM.

Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre,

Faculdade de Medicina, Universidade Federal do Rio Grande do Sul,

Porto Alegre, Rio Grande do Sul, Brazil.

We evaluated the efficacy of acupuncture as a useful adjuvant

treatment in the management of rheumatoid arthritis (RA). A pilot,

randomized, double-blind, and controlled clinical trial was conducted.

Forty RA patients with active disease despite stable therapy for at

least the preceding 1 month were randomized to receive a standard

protocol of acupuncture (AC) or superficial acupuncture at

non-acupuncture points (controlAC) for 9 weeks. The primary outcome

was achievement of 20% improvement according to the American College

of Rheumatology (ACR) 20 criteria after five and ten treatment

sessions and after 1 month of follow-up. Secondary measures included

Disease Assessment Scale (DAS), tender and swollen joint count,

morning stiffness, Health Assessment Questionnaire (HAQ), visual

analogue scale (VAS) of pain, physician global assessment of activity

disease, physician and patient global assessment of treatment, and

inflammatory markers (erythrocyte sedimentation rate and C-reactive

protein). There was not significant difference between the groups

regarding the number of patients that reached ACR20 at the end of the

treatment (p = 0.479). However, after 1 month of follow-up, there was

a trend in favor of the AC group, with p = 0,068. Compared with the

controlAC, the AC group also demonstrated significant improvement in

the patient and physician global assessment of treatment and physician

global assessment of disease activity, but there was no difference on

other clinical and laboratorial measures. On the other hand, only the

AC patients had within group improvement on the variables DAS, HAQ,

morning stiffness, patient and physician global assessment of

treatment, and physician global assessment of disease activity in

comparison to baseline visit. Despite the improvement of some studied

variables, there was no significant difference in the proportion of

patients that reached ACR20 between the AC and controlAC groups. This

negative result can be related to the small sample size, selection of

patients, type of acupuncture protocol applied, and difficulties in

establishing an innocuous and trustworthy placebo group to studies

involving acupuncture.

PMID: 17989918

http://www.ncbi.nlm.nih.gov/pubmed/17989918

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