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Effectiveness of Acupuncture on Pain, Physical Function and Health-Related Quality of Life in Patients with Rheumatoid Arthritis: A Systematic Review of Quantitative Evidence

  • Susana Seca
  • Diana Miranda
  • Daniela Cardoso
  • Bernice Nogueira
  • Henry J. Greten
  • António Cabrita
  • Manuel Alves Rodrigues
Evidence-Based Integrative Medicine
  • 26 Downloads

Abstract

Objective

To identify and synthesize the most recent available evidence of effectiveness of acupuncture on pain, physical function and health-related quality of life (HRQoL) in patients with rheumatoid arthritis (RA).

Methods

A comprehensive search of 12 Western and Chinese databases was undertaken from their inception up to end of 2016. Randomized controlled trials (RCTs), concerning patients with RA treated with needle acupuncture, written in English, Portuguese, German or Chinese were included. Primary outcomes included pain, physical function and HRQoL. Secondary outcomes included morning stiffness, functional impairment, number of tender and swollen joints and serum concentrations of inflamatory markers. Methodological quality was assessed by three independent reviewers using the standardized critical appraisal instrument from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument.

Results

Twenty-two studies met the inclusion criteria. Of those, 9 studies were excluded after assessment of their methodological quality. The remaining 13 original RCTs included 974 patients. Ten of these studies published in China, showed favorable statistical significant effects of acupuncture in relieving symptoms of RA compared with controls.

Conclusions

Evidence suggests that acupuncture interventions may have a positive effect in pain relief, physical function and HRQoL in RA patients. However, due to the heterogeneity and methodologic limitations of the studies included in this systematic review, evidence is not strong enough to produce a best practice guideline.

Keywords

acupuncture rheumatoid arthritis quality of life pain physical function randomized clinical trial 

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Supplementary material

11655_2018_2914_MOESM1_ESM.pdf (154 kb)
Appendix 1: Search strategy

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Copyright information

© Chinese Association of the Integration of Traditional and Western Medicine 2018

Authors and Affiliations

  • Susana Seca
    • 1
    • 2
    • 5
  • Diana Miranda
    • 2
  • Daniela Cardoso
    • 3
  • Bernice Nogueira
    • 4
  • Henry J. Greten
    • 2
    • 5
  • António Cabrita
    • 1
  • Manuel Alves Rodrigues
    • 3
  1. 1.Faculty of MedicineUniversity of CoimbraCoimbraPortugal
  2. 2.Institute of Science Biomedicine Abel SalazarUniversity of PortoPortoPortugal
  3. 3.Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC)Portugal Centre for Evidence Based Practice: A Joanna Briggs Institute Centre of ExcellenceCoimbraPortugal
  4. 4.School of Health SciencesMacao Polytechnic Institute Macao SARMacaoChina
  5. 5.Heidelberg School of Chinese MedicineHeidelbergGermany

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