RESEARCH - Acupuncture in the treatment of RA: a double-blind controlled pilot study

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BMC Complement Altern Med. 2007; 7: 35.

Published online 2007 November 3. doi: 10.1186/1472-6882-7-35.

Acupuncture in the treatment of rheumatoid arthritis: a double-blind

controlled pilot study

Lai-Shan Tam,1 Ping-Chung Leung,2 Tena K Li,1 Lang Zhang,2 and Edmund K Li1

1The Department of Medicine & Therapeutics, The Prince of Wales

Hospital, The Chinese University of Hong Kong, Hong Kong, China

2The Institute of Chinese Medicine, The Prince of Wales Hospital, The

Chinese University of Hong Kong, Hong Kong, China

Abstract

Background

In planning a randomized controlled trial of acupuncture, we conducted

a pilot study using validated outcome measures to assess the

feasibility of the protocol, and to obtain preliminary data on

efficacy and tolerability of 3 different forms of acupuncture

treatment as an adjunct for the treatment of chronic pain in patients

with Rheumatoid arthritis (RA).

Methods

The study employs a randomized, prospective, double-blind,

placebo-controlled trial to evaluate the effect of electroacupuncture

(EA), traditional Chinese acupuncture (TCA) and sham acupuncture

(Sham) in patients with RA. All patients received 20 sessions over a

period of 10 weeks. Six acupuncture points were chosen. Primary

outcome is the changes in the pain score. Secondary outcomes included

the changes in the ACR core disease measures, DAS 28 score and the

number of patients who achieved ACR 20 at week 10.

Results

From 80 eligible patients, 36 patients with mean age of 58 ± 10 years

and disease duration of 9.3 ± 6.4 years were recruited. Twelve

patients were randomized to each group. Twelve, 10 and 7 patients from

the EA, TCA and Sham group respectively completed the study at 20

weeks (p < 0.03); all except one of the premature dropouts were due to

lack of efficacy. At week 10, the pain score remained unchanged in all

3 groups. The number of tender joints was significantly reduced for

the EA and TCA groups. Physician's global score was significantly

reduced for the EA group and patient's global score was significantly

reduced for the TCA group. All the outcomes except patient's global

score remained unchanged in the Sham group.

Conclusion

This pilot study has allowed a number of recommendations to be made to

facilitate the design of a large-scale trial, which in turn will help

to clarify the existing evidence base on acupuncture for RA.

Trial registration

ClinicalTrials.gov NCT00404443

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