RESEARCH - Efficacy of acupuncture in fibromyalgia syndrome

[Guest guest]

Rheumatology Advance Access published online on January 25, 2010

Rheumatology, doi:10.1093/rheumatology/kep439

Efficacy of acupuncture in fibromyalgia syndrome—a systematic review

with a meta-analysis of controlled clinical trials

Jost Langhorst1, Petra Klose1, Frauke Musial1, Dominik Irnich2 and

Winfried Häuser3,4

1Department of Internal Medicine V, (Complementary and Integrative

Medicine), University of Duisburg-Essen, Kliniken Essen-Mitte,

2Department of Anesthesiology, Multidisciplinary Pain Center, Ludwig

Maximilian Universität München, Munich, 3Department of Internal

Medicine I, Klinikum Saarbrücken, Saarbrücken and 4Department of

Psychosomatic Medicine, Technische Universität München, Munich,

Germany.

Abstract

Objective. To systematically review the efficacy of acupuncture in

fibromyalgia syndrome (FMS).

Methods. MEDLINE, PsychInfo, EMBASE, CAMBASE and the Cochrane Library

were screened (through July 2009). The reference sections of original

studies and systematic reviews for randomized controlled trials (RCTs)

on acupuncture in FMS were searched.

Results. Seven RCTs with a median treatment time of 9 (range 6–25)

sessions and 385 patients were included. Outcomes of interest were key

symptoms of FMS, namely pain, fatigue, sleep disturbances, reduced

physical function and side effects at post-treatment. Follow-up of two

RCTs with a median follow-up of 26 weeks was available. Standardized

mean differences (SMDs) comparing verum and control acupuncture were

calculated. Strong evidence for the reduction of pain (SMD –0.25; 95%

CI –0.49, –0.02; P = 0.04) was found at post-treatment. There was no

evidence for the reduction of fatigue and sleep disturbances, or the

improvement of physical function at post-treatment. There was no

evidence for the reduction of pain and improvement of physical

function at the latest follow-up. Subgroup analyses resulted in

moderate evidence for a significant and small reduction of pain at

post-treatment in studies with electro-stimulation and individualized

acupuncture. Stratifying the type of controls (penetrating vs

non-penetrating control acupuncture) did not change the results.

Significant reduction of pain was only present in studies with risk of

bias. Side effects were inconsistently reported.

Conclusion. A small analgesic effect of acupuncture was present,

which, however, was not clearly distinguishable from bias. Thus,

acupuncture cannot be recommended for the management of FMS.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/kep439v1?papetoc

Not an MD