medwireNews: Acupuncture could serve as a non-pharmacologic option to treat aromatase inhibitor (AI)-related arthralgias in postmenopausal women with stage I–III breast cancer, suggest phase III trial results showing improvements in joint symptoms with acupuncture relative to controls.
In the SWOG S1200 study, patients who had been taking an AI for 30 days or more and reported a worst pain score of at least 3 on the Brief Pain Inventory (BPI) were randomly assigned to receive either true or sham acupuncture (n=110 and 59, respectively).
Both groups received a standardized 12-week intervention, with two sessions per week for the first 6 weeks and a weekly session for the next 6 weeks, but the true protocol used body and auricular acupoints specific to joint symptoms, while the sham protocol involved superficial insertion in non-acupoints. An additional 57 women were allocated to a waitlist control group.
At the 6-week mark, the average worst pain score on the BPI in the true acupuncture group was 0.92 and 0.96 points lower than the sham acupuncture and waitlist control groups, respectively, after adjusting for baseline score and study site, a significant difference in both cases.
And the proportion of patients who experienced a clinically meaningful decrease of more than 2 points in the BPI worst pain score was significantly higher in the true acupuncture versus the sham acupuncture and waitlist control groups, with corresponding rates of 58%, 33%, and 31%.
The results were similar at week 12, and true acupuncture was also associated with significant improvements in other measures relative to the sham procedure or waitlisting, such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, for the hip and knee joints) and the Modified Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (M-SACRAH), at the 6 and 12 week timepoints.
Study author Dawn Hershman (Columbia University Medical Center, New York, USA) who presented the findings at the 2017 San Antonio Breast Cancer Symposium in Texas, USA, highlighted that the positive effects of the intervention were maintained up to 12 weeks after completion.
The most frequently reported side effect in the true and sham acupuncture treatment arms was grade 1 bruising, with a significantly higher occurrence among those who received the true procedure, at 47% and 25%, respectively. Other adverse events, such as dizziness and injection site bleeding, were infrequent and did not differ significantly by treatment group.
“For patients reluctant to take a prescription medication, that can result in other side effects, acupuncture provides a safe and effective alternative,” concluded Hershman.
She added in a press release: “We hope that by reducing the debilitating side effects of [AI] treatment, acupuncture may improve adherence to treatment and thereby outcomes, but we need to conduct further studies to determine if this is indeed the case.”
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