Acupuncture may provide limited relief for patients with chronic urticaria

A randomized controlled trial of more than 300 people diagnosed with chronic spontaneous urticaria (CSU), or hives, found that acupuncture may provide limited symptom relief; The clinical significance of this finding was unclear. This research Annals of Internal Medicine.

CSU is the most common form of chronic urticaria and is characterized by recurrent itching, skin lesions, or swelling that lasts for more than 6 weeks in the absence of a specific provoking factor. More than 90% of CSU patients require urgent treatment to relieve itching. Therefore, itch management is one of the main goals in the treatment of CSU.

Researchers at Chengdu University of Traditional Chinese Medicine randomly assigned 330 people diagnosed with CSU to either 4 weeks of acupuncture, 4 weeks of sham acupuncture, or a waiting list (control) for 4 weeks after treatment. They followed patients to see if acupuncture was effective. It leads to improvement of symptoms of CSU. Symptom changes were measured using the Weekly Urticaria Activity Score (UAS7).

Patients in the acupuncture group reported improved UAS7 compared to sham acupuncture and waitlist management. However, the clinical significance of the observed reduction in itch severity scores is unclear, as the difference between intervention and control did not meet the minimum clinical difference (MCID) threshold. The incidence of adverse events was highest in the acupuncture group, but the adverse events were mild and transient.

An accompanying editorial by Mike Cummings of the British Medical Acupuncture Society highlights that these trial results are interesting because they illustrate the effectiveness of acupuncture in conditions not characterized by pain. Although the clinical significance of this finding is unclear, the authors caution that clinicians should always keep in mind the possibility of using acupuncture as an adjunct to influence outcomes, even in more severe conditions. It suggests that it should be left alone.

The editorial suggests that acupuncture is often ignored as a treatment because it lacks commercial support compared to other modern interventions.