Review does not support acupuncture for RA pain relief

There is scarce evidence supporting the use of acupuncture for pain relief in rheumatoid arthritis (RA), according to a recent systematic review. A previous review of the efficacy of acupuncture in RA was "limited by the methodological weakness inherent in the studies selected for inclusion," the researchers write in the latest edition of Arthritis Care and Research. Therefore, they undertook a more comprehensive systematic search for well-designed trials of acupuncture in RA patients with the objective of determining the efficacy of acupuncture on pain relief in patients with RA. Studies were only selected if patients were classified according to the American College of Rheumatology criteria and used a primary outcome measure of tender joint count and secondary measures, such as the effect of acupuncture on a pain scale. By analysing 12 western and Chinese databases the group identified four placebo-controlled trials and four active-controlled trials, comprising 536 subjects, which met the eligibility criteria. Overall, six studies reported a decrease in pain for acupuncture versus controls and four studies reported a significant reduction in morning stiffness (mean change -29 minutes), but the difference was non-significant versus controls. With regard to inflammatory markers, five studies observed a reduction in ESR (mean change -3.9 mm/hour) and three described a CRP level reduction (mean change -2.9 mg/dl), with one study showing a significant difference for both ESR and CRP. Despite some favourable results, the authors comment that the overall data was insufficient to support the efficacy of acupuncture in RA. Future large-scale acupuncture studies should have double-blind, randomised, placebo-controlled designs, and use appropriate control groups and validated longer-term outcome measures for RA, the group concluded. Reference Wang, C. de Pablo, P. Chen, X. et al. 2008, ‘Acupuncture for pain relief in patients with rheumatoid arthritis: A systematic review’ Arthritis Care and Research, Vol. 59, pp. 1249-1256....