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A pilot study of acupuncture as adjunctive treatment of rheumatoid arthritis

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Abstract

We evaluated the efficacy of acupuncture as a useful adjuvant treatment in the management of rheumatoid arthritis (RA). A pilot, randomized, double-blind, and controlled clinical trial was conducted. Forty RA patients with active disease despite stable therapy for at least the preceding 1 month were randomized to receive a standard protocol of acupuncture (AC) or superficial acupuncture at non-acupuncture points (controlAC) for 9 weeks. The primary outcome was achievement of 20% improvement according to the American College of Rheumatology (ACR) 20 criteria after five and ten treatment sessions and after 1 month of follow-up. Secondary measures included Disease Assessment Scale (DAS), tender and swollen joint count, morning stiffness, Health Assessment Questionnaire (HAQ), visual analogue scale (VAS) of pain, physician global assessment of activity disease, physician and patient global assessment of treatment, and inflammatory markers (erythrocyte sedimentation rate and C-reactive protein). There was not significant difference between the groups regarding the number of patients that reached ACR20 at the end of the treatment (p = 0.479). However, after 1 month of follow-up, there was a trend in favor of the AC group, with p = 0,068. Compared with the controlAC, the AC group also demonstrated significant improvement in the patient and physician global assessment of treatment and physician global assessment of disease activity, but there was no difference on other clinical and laboratorial measures. On the other hand, only the AC patients had within group improvement on the variables DAS, HAQ, morning stiffness, patient and physician global assessment of treatment, and physician global assessment of disease activity in comparison to baseline visit. Despite the improvement of some studied variables, there was no significant difference in the proportion of patients that reached ACR20 between the AC and controlAC groups. This negative result can be related to the small sample size, selection of patients, type of acupuncture protocol applied, and difficulties in establishing an innocuous and trustworthy placebo group to studies involving acupuncture.

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Authors and Affiliations

  1. Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Simone de Azevedo Zanette, Ilca Greca Born, João Carlos Tavares Brenol & Ricardo Machado Xavier

  2. Serviço de Medicina de Reabilitação do Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350/zona 2, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil

    Simone de Azevedo Zanette

  3. Serviço de Reumatologia do Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350/ sala 645, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil

    Ricardo Machado Xavier

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  1. Simone de Azevedo Zanette
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  2. Ilca Greca Born
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  3. João Carlos Tavares Brenol
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  4. Ricardo Machado Xavier
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Correspondence to Simone de Azevedo Zanette or Ricardo Machado Xavier.

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Zanette, S.A., Born, I.G., Brenol, J.C.T. et al. A pilot study of acupuncture as adjunctive treatment of rheumatoid arthritis. Clin Rheumatol 27, 627–635 (2008). https://doi.org/10.1007/s10067-007-0759-y

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  • DOI: https://doi.org/10.1007/s10067-007-0759-y

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