Acupuncture benefits unclear for aromatase inhibitor–related athralgia
medwireNews: Acupuncture may provide modest reductions in aromatase inhibitor-related joint pain in postmenopausal women with early-stage breast cancer, results of a multicenter study suggest.
The randomized clinical trial, conducted at 11 academic centers and clinical sites in the USA, included 226 postmenopausal women (mean age, 60.7 years) who scored at least 3 on the Brief Pain Inventory Worst Pain (BPI-WP) item scale (mean baseline score, 6.6).
The women were randomly assigned to receive two true or sham acupuncture sessions per week for 6 weeks, followed by one session per week for 6 weeks, or to a waitlist control group that did not receive any intervention.
From baseline to 6 weeks, the mean observed BPI-WP item score decreased by 2.05 points in the 110 participants who received true acupuncture, by 1.07 points in the 59 participants who underwent sham acupuncture, and by 0.99 points in the 57 participants placed on the waitlist.
After adjustment for baseline pain and study site variables, there were significant 0.92- and 0.96-point greater reductions in BPI-WP score with true acupuncture than with sham acupuncture and waitlist control, respectively.
However, the researchers note that although the magnitude of the reduction was greater with true acupuncture, it did not meet the prespecified between-group difference of 2.0 points considered clinically meaningful.
Nonetheless, a post-hoc analysis showed that the proportion of patients with a 2-point reduction in BPI-WP score at 6 weeks was greater in the true acupuncture group (58%) than in the sham acupuncture (33%) and waitlist control (31%) groups.
At 12 weeks, average pain, worst pain, pain interference, pain severity, and worst stiffness were all significantly lower in the true acupuncture group than in the waitlist control group, but only average pain was reduced with true acupuncture versus sham acupuncture.
Dawn Hershman (Columbia University, New York, USA) and co-authors conclude in JAMA that although acupuncture was associated with a statistically significant reduction in joint pain at 6 weeks, “the magnitude of the improvement was of uncertain clinical importance.”
By Laura Cowen
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