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Published in: BMC Complementary Medicine and Therapies 1/2007

Open Access 01-12-2007 | Research article

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

Authors: Lai-Shan Tam, Ping-Chung Leung, Tena K Li, Lang Zhang, Edmund K Li

Published in: BMC Complementary Medicine and Therapies | Issue 1/2007

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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
Appendix
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Literature
1.
go back to reference Herman CJ, Allen P, Hunt WC, Prasad A, Brady TJ: Use of complementary therapies among primary care clinic patients with arthritis. Prev Chronic Dis. 2004, 1: A12-PubMedPubMedCentral Herman CJ, Allen P, Hunt WC, Prasad A, Brady TJ: Use of complementary therapies among primary care clinic patients with arthritis. Prev Chronic Dis. 2004, 1: A12-PubMedPubMedCentral
2.
go back to reference White A, Foster NE, Cummings M, Barlas P: Acupuncture treatment for chronic knee pain: a systematic review. Rheumatology. 2007, 46 (3): 384-390. 10.1093/rheumatology/kel413.CrossRefPubMed White A, Foster NE, Cummings M, Barlas P: Acupuncture treatment for chronic knee pain: a systematic review. Rheumatology. 2007, 46 (3): 384-390. 10.1093/rheumatology/kel413.CrossRefPubMed
3.
go back to reference Trinh K, Graham N, Gross A, Goldsmith C, Wang E, Cameron I, Kay T: Acupuncture for neck disorders. Spine. 2007, 32 (2): 236-243. 10.1097/01.brs.0000252100.61002.d4.CrossRefPubMed Trinh K, Graham N, Gross A, Goldsmith C, Wang E, Cameron I, Kay T: Acupuncture for neck disorders. Spine. 2007, 32 (2): 236-243. 10.1097/01.brs.0000252100.61002.d4.CrossRefPubMed
4.
go back to reference Stux G, Pomeranz, B: Basics of Acupuncture. 1995, Berlin , Springer-Verlag, 3rd Stux G, Pomeranz, B: Basics of Acupuncture. 1995, Berlin , Springer-Verlag, 3rd
5.
go back to reference Lao L: Acupuncture techniques and devices. J Altern Complement Med. 1996, 2 (1): 23-5. 10.1089/acm.1996.2.23.CrossRefPubMed Lao L: Acupuncture techniques and devices. J Altern Complement Med. 1996, 2 (1): 23-5. 10.1089/acm.1996.2.23.CrossRefPubMed
6.
go back to reference Ezzo J, Berman, B., Hadhazy, V.A., Jadad, A.R., Lao, L., Singh, B.B: Is acupuncture effective for the treatment of chronic pain? A systematic review. Pain. 2000, 86: 217-225. 10.1016/S0304-3959(99)00304-8.CrossRefPubMed Ezzo J, Berman, B., Hadhazy, V.A., Jadad, A.R., Lao, L., Singh, B.B: Is acupuncture effective for the treatment of chronic pain? A systematic review. Pain. 2000, 86: 217-225. 10.1016/S0304-3959(99)00304-8.CrossRefPubMed
7.
go back to reference Witt CM, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich SN: Acupuncture in patients with osteoarthritis of the knee or hip: A randomized, controlled trial with an additional nonrandomized arm. Arthritis & Rheumatism. 2006, 54 (11): 3485-3493. 10.1002/art.22154.CrossRef Witt CM, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich SN: Acupuncture in patients with osteoarthritis of the knee or hip: A randomized, controlled trial with an additional nonrandomized arm. Arthritis & Rheumatism. 2006, 54 (11): 3485-3493. 10.1002/art.22154.CrossRef
8.
go back to reference Scharf HP, Mansmann U, Streitberger K, Witte S, Kramer J, Maier C, Trampisch HJ, Victor N: Acupuncture and Knee Osteoarthritis: A Three-Armed Randomized Trial. Ann Intern Med. 2006, 145 (1): 12-20.CrossRefPubMed Scharf HP, Mansmann U, Streitberger K, Witte S, Kramer J, Maier C, Trampisch HJ, Victor N: Acupuncture and Knee Osteoarthritis: A Three-Armed Randomized Trial. Ann Intern Med. 2006, 145 (1): 12-20.CrossRefPubMed
9.
go back to reference Kwon YD, Pittler MH, Ernst E: Acupuncture for peripheral joint osteoarthritis: A systematic review and meta-analysis. Rheumatology. 2006, 45 (11): 1331-1337. 10.1093/rheumatology/kel207.CrossRefPubMed Kwon YD, Pittler MH, Ernst E: Acupuncture for peripheral joint osteoarthritis: A systematic review and meta-analysis. Rheumatology. 2006, 45 (11): 1331-1337. 10.1093/rheumatology/kel207.CrossRefPubMed
10.
go back to reference Man SC, Baragar FD: Preliminary clinical study of acupuncture in rheumatoid arthritis. J Rheumatol. 1974, 1 (1): 126-129.PubMed Man SC, Baragar FD: Preliminary clinical study of acupuncture in rheumatoid arthritis. J Rheumatol. 1974, 1 (1): 126-129.PubMed
11.
go back to reference David J, Townsend S, Sathanathan R, Kriss S, Dore CJ: The effect of acupuncture on patients with rheumatoid arthritis: a randomized, placebo-controlled cross-over study. Rheumatology (Oxford). 1999, 38 (9): 864-869. 10.1093/rheumatology/38.9.864.CrossRef David J, Townsend S, Sathanathan R, Kriss S, Dore CJ: The effect of acupuncture on patients with rheumatoid arthritis: a randomized, placebo-controlled cross-over study. Rheumatology (Oxford). 1999, 38 (9): 864-869. 10.1093/rheumatology/38.9.864.CrossRef
12.
go back to reference Casimiro L, Barnsley L, Brosseau L, Milne S, Robinson VA, Tugwell P, Wells G: Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2005, CD003788.- Casimiro L, Barnsley L, Brosseau L, Milne S, Robinson VA, Tugwell P, Wells G: Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2005, CD003788.-
13.
go back to reference Tukmachi E: Acupuncture and rheumatoid arthritis. Rheumatology (Oxford). 2000, 39 (10): 1153-1154. 10.1093/rheumatology/39.10.1153.CrossRef Tukmachi E: Acupuncture and rheumatoid arthritis. Rheumatology (Oxford). 2000, 39 (10): 1153-1154. 10.1093/rheumatology/39.10.1153.CrossRef
14.
go back to reference Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra H: The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis and Rheumatism. 1988, 31: 315-324. 10.1002/art.1780310302.CrossRefPubMed Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra H: The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis and Rheumatism. 1988, 31: 315-324. 10.1002/art.1780310302.CrossRefPubMed
15.
go back to reference Leung PC, Wong EL, Zhang L: Introducing Placebo Practice in Clinical Trials Using Acupuncture-Is it a Realistic Policy?. Journal of Alternative and Complementary Medicine. 2006, , Leung PC, Wong EL, Zhang L: Introducing Placebo Practice in Clinical Trials Using Acupuncture-Is it a Realistic Policy?. Journal of Alternative and Complementary Medicine. 2006, ,
16.
go back to reference Karst M, Rollnik JD, Fink M, Reinhard M, Piepenbrock S: Pressure pain threshold and needle acupuncture in chronic tension-type headache--a double-blind placebo-controlled study. Pain. 2000, 88 (2): 199-203. 10.1016/S0304-3959(00)00315-8.CrossRefPubMed Karst M, Rollnik JD, Fink M, Reinhard M, Piepenbrock S: Pressure pain threshold and needle acupuncture in chronic tension-type headache--a double-blind placebo-controlled study. Pain. 2000, 88 (2): 199-203. 10.1016/S0304-3959(00)00315-8.CrossRefPubMed
17.
go back to reference Huang QF, Qi LZ: Acupuncture is effective for the treatment of 54 diseases. 2002, Shanghai Scientific & Technical Publishers, 100104- Huang QF, Qi LZ: Acupuncture is effective for the treatment of 54 diseases. 2002, Shanghai Scientific & Technical Publishers, 100104-
18.
go back to reference Koh ET, Seow A, Pong LY, Koh WH, Chan L, Howe HS, Lim TH, Low CK: Cross cultural adaptation and validation of the Chinese Health Assessment Questionnaire for use in rheumatoid arthritis. J Rheumatol. 1998, 25: 1705-1708.PubMed Koh ET, Seow A, Pong LY, Koh WH, Chan L, Howe HS, Lim TH, Low CK: Cross cultural adaptation and validation of the Chinese Health Assessment Questionnaire for use in rheumatoid arthritis. J Rheumatol. 1998, 25: 1705-1708.PubMed
19.
go back to reference Shen AC, Whitehouse MJ, Powers TR, Rhodes CY, Engleman EP: Pilot Study of the Effects of Acupuncture in Rheumatoid Arthritis. Arthritis Rheum. 1973, 569-570. Shen AC, Whitehouse MJ, Powers TR, Rhodes CY, Engleman EP: Pilot Study of the Effects of Acupuncture in Rheumatoid Arthritis. Arthritis Rheum. 1973, 569-570.
20.
go back to reference Man PL, Chen CH: Acupuncture for pain relief, a double-blind, self-controlled study. Michigan Medicine. 1974, 73 (2): 15-18.PubMed Man PL, Chen CH: Acupuncture for pain relief, a double-blind, self-controlled study. Michigan Medicine. 1974, 73 (2): 15-18.PubMed
21.
go back to reference Lee PK, Andersen TW, Modell JH, Saga SA: Treatment of chronic pain with acupuncture. JAMA. 1975, 232: 1133-1135. 10.1001/jama.232.11.1133.CrossRefPubMed Lee PK, Andersen TW, Modell JH, Saga SA: Treatment of chronic pain with acupuncture. JAMA. 1975, 232: 1133-1135. 10.1001/jama.232.11.1133.CrossRefPubMed
22.
go back to reference Camerlain M, Leung CY, Santerre A, Munan L, Myhal D: [Evaluation of acupuncture in rheumatoid arthritis]. Union Med Can. 1981, 110 (12): 1041-1044.PubMed Camerlain M, Leung CY, Santerre A, Munan L, Myhal D: [Evaluation of acupuncture in rheumatoid arthritis]. Union Med Can. 1981, 110 (12): 1041-1044.PubMed
23.
go back to reference Stritberger K, Kleinhenz J: Introducing a placebo needle into acupuncture research. Lancet. 1998, 352: 364-365. 10.1016/S0140-6736(97)10471-8.CrossRef Stritberger K, Kleinhenz J: Introducing a placebo needle into acupuncture research. Lancet. 1998, 352: 364-365. 10.1016/S0140-6736(97)10471-8.CrossRef
24.
go back to reference Park J, White A, Stevinson C, Ernst E, James M: Validating a new non-penetrating sham acupuncture device: two randomised controlled trials. Acupunct Med. 2002, 20 (4): 168-174.CrossRefPubMed Park J, White A, Stevinson C, Ernst E, James M: Validating a new non-penetrating sham acupuncture device: two randomised controlled trials. Acupunct Med. 2002, 20 (4): 168-174.CrossRefPubMed
25.
go back to reference Tsukayama H, Yamashita H, Kimura T, Otsuki K: Factors that influence the applicability of sham needle in acupuncture trials: two randomized, single-blind, crossover trials with acupuncture-experienced subjects. Clin J Pain. 2006, 22 (4): 346-349. 10.1097/01.ajp.0000176359.94644.mL.CrossRefPubMed Tsukayama H, Yamashita H, Kimura T, Otsuki K: Factors that influence the applicability of sham needle in acupuncture trials: two randomized, single-blind, crossover trials with acupuncture-experienced subjects. Clin J Pain. 2006, 22 (4): 346-349. 10.1097/01.ajp.0000176359.94644.mL.CrossRefPubMed
26.
go back to reference Bhatt-Sanders D: Acupuncture for rheumatoid arthritis: an analysis of the literature. Semin Arthritis Rheum. 1985, 14 (4): 225-231. 10.1016/0049-0172(85)90041-1.CrossRefPubMed Bhatt-Sanders D: Acupuncture for rheumatoid arthritis: an analysis of the literature. Semin Arthritis Rheum. 1985, 14 (4): 225-231. 10.1016/0049-0172(85)90041-1.CrossRefPubMed
27.
go back to reference Ross J: Acupuncture point combinations: the key to clinical success. 1995, Edinburgh , Churchill Livingstone, 370-372. Ross J: Acupuncture point combinations: the key to clinical success. 1995, Edinburgh , Churchill Livingstone, 370-372.
28.
go back to reference Angelini M, Carrabba M, Egitto A, Rogora GA, Storer C: [Acupuncture in rheumatology. Case contribution]. Minerva Med. 1982, 73 (30-31): 2031-2038.PubMed Angelini M, Carrabba M, Egitto A, Rogora GA, Storer C: [Acupuncture in rheumatology. Case contribution]. Minerva Med. 1982, 73 (30-31): 2031-2038.PubMed
29.
go back to reference Benenson EV, Dribina OG: [Clinical effectiveness and mechanism of action of electroacupuncture of the ear in rheumatoid arthritis]. Ter Arkh. 1981, 53 (3): 42-46.PubMed Benenson EV, Dribina OG: [Clinical effectiveness and mechanism of action of electroacupuncture of the ear in rheumatoid arthritis]. Ter Arkh. 1981, 53 (3): 42-46.PubMed
30.
go back to reference Zijlstra FJ, van den Berg-de Lange I, Huygen FJ, Klein J: Anti-inflammatory actions of acupuncture. Mediators Inflamm. 2003, 12 (2): 59-69. 10.1080/0962935031000114943.CrossRefPubMedPubMedCentral Zijlstra FJ, van den Berg-de Lange I, Huygen FJ, Klein J: Anti-inflammatory actions of acupuncture. Mediators Inflamm. 2003, 12 (2): 59-69. 10.1080/0962935031000114943.CrossRefPubMedPubMedCentral
31.
go back to reference Hogeboom CJ, Sherman KJ, Cherkin DC: Variation in diagnosis and treatment of chronic low back pain by traditional Chinese medicine acupuncturists. Complement Ther Med. 2001, 9 (3): 154-166. 10.1054/ctim.2001.0457.CrossRefPubMed Hogeboom CJ, Sherman KJ, Cherkin DC: Variation in diagnosis and treatment of chronic low back pain by traditional Chinese medicine acupuncturists. Complement Ther Med. 2001, 9 (3): 154-166. 10.1054/ctim.2001.0457.CrossRefPubMed
Metadata
Title
Acupuncture in the treatment of rheumatoid arthritis: a double-blind controlled pilot study
Authors
Lai-Shan Tam
Ping-Chung Leung
Tena K Li
Lang Zhang
Edmund K Li
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2007
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/1472-6882-7-35

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