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A randomized controlled trial of more than 300 participants with chronic spontaneous urticaria provides new insights into the effects of acupuncture on disease symptoms and quality of life.
In a trial comparing acupuncture with sham acupuncture and a waiting list control, which used the Weekly Urticaria Activity Score (UAS7) to assess treatment efficacy, acupuncture was associated with greater improvement in UAS7. However, the association they noted did not reach the threshold of statistical significance.1
“Primary and secondary outcome results suggested greater improvement for patients. [chronic spontaneous urticaria] Although the clinical significance is unknown, participants who received 16 acupuncture treatments over a 4-week period had greater symptoms than participants who received sham acupuncture treatments or a wait-list control group.” is writing.1
Chronic spontaneous urticaria, the result of an autoimmune mechanism, is defined as the development of widespread wheals, angioedema, or both that lasts for more than 6 weeks and is estimated to affect 1-2% of the general population and is more common in female patients. Prevalence is higher. It is more common in patients over 20 years of age.2
A research team led by Ying Li, M.D., Ph.D., of Chengdu University of Traditional Chinese Medicine, cited previous evidence suggesting that acupuncture may inhibit the peripheral and central transmission of pruritus. We sought to build on the existing evidence base surrounding this. In the current trial, researchers randomly assigned patients in a 1:1:1 ratio to receive acupuncture treatment or sham acupuncture over an 8-week study period, consisting of 4 weeks of treatment and 4 weeks of follow-up. They either received treatment or were placed on a waiting list control group.1
Patients in this study were recruited from the outpatient departments of three tertiary hospitals in three different cities in China. All patients were recruited through advertisements, questionnaires, and hospital posters and were screened for eligibility by dermatologists at each participating center.1
Those randomized to acupuncture received 10 sessions in the first two weeks and six additional sessions in the subsequent two weeks for a total of 16 sessions. These sessions lasted him 30 minutes. Subjects in the sham group received the same number of sessions and received non-penetrating acupuncture at sham acupuncture points.1
The primary outcome of interest in this study was the mean change from baseline to week 4 in UAS7. The trial also included multiple secondary outcomes, including itch severity scores, self-rated improvement, and dermatology quality of life index scores.1
Analysis suggested that the mean change in UAS7 from baseline to week 4 was greater in the acupuncture group (-8.2; 95% confidence interval) [CI], -9.9 to -6.6) than the sham acupuncture group (-4.1; 95% CI, -5.8 to -2.4) and the waitlist control group (-2.2; 95% CI, -3.8 to -0.5). The researchers found a significant difference between acupuncture and sham acupuncture (-4.1; 95% CI, -6.5 to -1.8) and acupuncture and waitlist control (-6.1; 95% CI, -8.4 to -3.7). We noted that the mean differences seen did not meet the threshold. Clinically important differences are minimized.1
When assessing safety, results showed that 13.6% of patients in the acupuncture group reported adverse events, compared to no adverse events in the other groups. However, the researchers noted that all adverse events that occurred during the trial were considered mild or transient.1
The researchers noted that there are several limitations that should be considered when interpreting the trial results. These include the relatively short study period, the employment of an intensive acupuncture regimen, and the comparison with acupuncture without or only occasional use of antihistamines.1
“Although the acupuncture treatments studied were fairly intensive, totaling 16 sessions over four weeks, it is noteworthy that the effects of acupuncture persisted for one month after the end of the acupuncture treatment,” the researchers wrote. added.1 “Further studies should examine whether similar effects can be seen with less acupuncture.”
References:
- Zheng H, Xiao XJ, Shi YZ et al. Efficacy of acupuncture treatment for chronic spontaneous urticaria: a randomized controlled trial [published online ahead of print, 2023 Nov 14]. Ann Intern Med. 2023;10.7326/M23-1043. doi:10.7326/M23-1043
- Murdaca G, Paladin F, Borro M, Ricciardi L, Gangemi S. Prevalence of autoimmune and autoinflammatory diseases in chronic urticaria: implications for pathogenesis, diagnosis, and treatment. biomedical science. 2023;11(2):410. Published January 30, 2023. doi:10.3390/biomedicines11020410
