In a recent study published in BMJ Open, A group of researchers evaluated the effectiveness of acupuncture in reducing the risk of ischemic stroke in patients with rheumatoid arthritis (RA).
study: Effect of acupuncture treatment on ischemic stroke in patients with rheumatoid arthritis: a nationwide propensity score matched study. Image credit: Andrey_Popov/Shutterstock.com
background
Rheumatoid arthritis is a widespread disease characterized by severe joint inflammation and complications such as bone erosion and cardiovascular disease, which particularly increases the risk of stroke. Globally, rheumatoid arthritis affects 460 people per 100,000 people, and similar stroke risks are observed in Asians and Caucasians.
Conventional treatments include nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, and traditional disease-modifying antirheumatic drugs (DMARDs). These can reduce the risk of stroke, but can cause side effects such as thrombocytopenia.
Acupuncture, widely used in various countries for rheumatoid arthritis and pain management, offers a potential alternative by reducing inflammation and the risk of stroke, making it a non-traditional therapy in the management of rheumatoid arthritis. This reflects the importance of exploring new interventions.
Further research is needed to clarify the causal relationship between acupuncture and reduced ischemic stroke risk in patients with rheumatoid arthritis.
About research
In this study, to ensure an extensive and detailed examination of rheumatoid arthritis patients, we focused on a specific subset, the Catastrophe Patient Registration Database (RCIPD), and data from Taiwan’s National Health Insurance Research Database (NHIRD). We used a comprehensive approach by analyzing the ‘Health outcomes. Personally identifying information has been removed to maintain confidentiality.
The ethics committee emphasized compliance with ethical standards and approved this study.
By employing a 1:1 propensity score matched cohort study design, researchers will compare the effects of acupuncture treatment on newly diagnosed rheumatoid arthritis patients with those who did not receive such treatment. We aimed to minimize bias and confounding factors.
Inclusion criteria were carefully defined to include only eligible rheumatoid arthritis patients who were <18 years of age, lacked complete data, experienced insurance discontinuation, or had a previous diagnosis of ischemic stroke. Patients were excluded.
This rigorous methodology facilitated balanced comparisons between acupuncture and non-acupuncture cohorts, using demographic and medical variables to ensure comparability.
This analysis includes a thorough evaluation of comorbidities and treatments, employing advanced statistical techniques to assess the impact of acupuncture on ischemic stroke risk in patients with RA, resulting in a robust and precise scientific investigation. We are demonstrating our commitment to
research result
In this study, researchers used a thorough process of 1:1 propensity score matching to compare the outcomes of rheumatoid arthritis patients who received acupuncture treatment with those who did not receive acupuncture treatment.
Matching criteria were broad, including gender, age, all comorbidities, medications including oral steroids, NSAIDs, and statins, all DMARDs, year of rheumatoid arthritis diagnosis, and index year.
This rigorous approach enrolled an equal number of patients (11,613) in each cohort of acupuncture and non-acupuncture groups.
A closer look at baseline characteristics, including gender, age, comorbidities, and prescription distribution, revealed striking similarities between the two cohorts. Most of the participants in both groups were women and were middle-aged and older, ranging in age from 40 to 59 years.
The most common comorbidity is hypertension, affecting more than 38% of patients, while other significant medical conditions have also been noted, including hyperlipidemia, congestive heart failure, diabetes, anxiety, and depression. .
This study found no significant differences in the incidence of alcohol dependence, tobacco dependence, or obesity between cohorts. NSAIDs were the main prescribed medications, and 76% of his patients were taking these medications.
Regarding treatment details, 87% of patients received manual acupuncture, 3% received electroacupuncture, and the remaining 10% received a combination of both techniques. On average, it took approximately 1065 days from the diagnosis of rheumatoid arthritis to the start of the first acupuncture treatment, and the number of visits per patient was on average 9.83.
Throughout the follow-up period, the study observed that 946 patients developed ischemic stroke. The incidence of this condition increases with age, indicating that older patients are at higher risk.
This study adjusted subdistribution hazard ratios (SHRs) for different age groups and comorbidities to reveal increased risks associated with diabetes, hypertension, and congestive heart failure.
However, an important finding of this study was a lower cumulative incidence of ischemic stroke in the acupuncture cohort compared with the non-acupuncture group, suggesting a potential protective effect of acupuncture against ischemic stroke in patients with RA. is emphasized.
This analysis further demonstrated that both male and female patients benefited from acupuncture in terms of stroke prevention, and the adjusted SHR was significantly lower for patients of different age groups and with different comorbidities. showed that the risk was reduced between
Notably, the positive impact of acupuncture on stroke risk was evident regardless of concurrent use of steroids, statins, or DMARDs.
To ensure the reliability of these findings, the researchers also conducted a discordance analysis to corroborate the initial results obtained through propensity score matching.
This study concludes with the conclusion that acupuncture can significantly reduce the risk of ischemic stroke in RA patients, providing valuable insight into the potential benefits of incorporating acupuncture into the management of RA. providing.
