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Therapeutic effects of acupuncture in patients with rheumatoid arthritis: a prospective study using 18F-FDG–PET

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Abstract

Objective

The purpose of this study was to investigate whether improvement of regional inflammatory findings in knee joints of rheumatoid arthritis (RA) could be detected by positron-emission tomography (PET) using 18F-Fluorodeoxyglucose (FDG) after acupuncture treatments, as well as improvement of systemic inflammatory markers.

Methods

Six RA patients (all female, 61 ± 12 years old) received 10 acupuncture treatments in 2 months, to 11 traditional acupuncture points around a knee joint considered effective on RA. A visual analogue scale (VAS) for intensity of pain, knee joint range of motion (ROM), face scale for patient mood, and modified health assessment questionnaire (MHAQ) for disability of daily activities were assessed just before and after acupuncture. Maximum standardized uptake value (SUVmax) and the volume with SUV more than 1.0 [Volume(SUV > 1)] on FDG–PET images as well as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were also measured before and after the treatments.

Results

VAS, ROM, face scale and MHAQ improved in all patients and significantly after acupuncture, but no significant change was detected in ESR, CRP, SUVmax, or Volume(SUV > 1).

Conclusions

Acupuncture relieves symptom, remedies physical function, and improves quality of life in RA patients, but may have no or very limited anti-inflammatory effect systemically. The regional effects of acupuncture are unlikely to be induced through reduction of regional inflammation. We believe this clinical study is the first step for elucidating therapeutic mechanisms of acupuncture, which must be important for the rational use and further development of acupuncture.

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Acknowledgments

We thank Dr. Chietsugu Kato of Department of Health Sciences, Hokkaido University, Sapporo, and Dr. Koichi Morita of Sousei Higashi Hospital, Sapporo for their assistance.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan

    Masami Sato, Tohru Shiga, Kenji Hirata, Shozo Okamoto, Tomohito Kamibayashi & Nagara Tamaki

  2. Shirakaba Acupuncture Moxibustion and Osteopathy, Sapporo, Hokkaido, Japan

    Masami Sato

  3. Diagnostic Imaging Group, Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan

    Masayuki Inubushi

  4. Rheumatic and Collagen Disease Center, Tokeidai Memorial Hospital, Sapporo, Hokkaido, Japan

    Kazuhide Tanimura

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  1. Masami Sato
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  2. Masayuki Inubushi
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  3. Tohru Shiga
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  4. Kenji Hirata
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  8. Nagara Tamaki
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Correspondence to Masayuki Inubushi.

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Sato, M., Inubushi, M., Shiga, T. et al. Therapeutic effects of acupuncture in patients with rheumatoid arthritis: a prospective study using 18F-FDG–PET. Ann Nucl Med 23, 311–316 (2009). https://doi.org/10.1007/s12149-009-0238-4

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  • DOI: https://doi.org/10.1007/s12149-009-0238-4

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