Acupuncture and OA of the Knee

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" Gregory wrote;

I just heard about this study. I'll see if I can get a hold of the

whole thing

 

 

Traditional Chinese Acupuncture is Effective as Adjunctive Therapy in

Patients with Osteoarthritis of the Knee

 

Category: 06 Osteoarthritis clinical aspects

 

Presentation Time: Tuesday, 10:45 a.m. - 11:00 a.m.

 

Marc Hochberg, Lixing Lao, Barker Bausell, Patricia Langenberg, Brian

Berman. University of Maryland, Baltimore, MD

 

Presentation Number: 1718

 

Purpose: A systematic review of randomized controlled trials (RCTs) of

traditional Chinese acupuncture (TCA) in patients with knee

osteoarthritis (OA) suggested that patients who received TCA had

improvement in both pain and function compared to controls; however,

all of the individual studies were small and had methodological

limitations (Arthritis Rheum 2001;44:819-25).

 

Methods: A multicenter 26-week NIH-funded RCT was conducted to assess

the efficacy of TCA compared with two control groups: sham acupuncture

(SA) and education. 570 patients with symptomatic knee OA, defined as

moderate or greater pain on a 5-point Likert scale despite background

therapy, who fulfilled ACR criteria were enrolled. Patients had a mean

[sD] age of 65.5 [8.6] years; 69% were white, 64% were women. 190

patients were randomized to each group in blocks of multiples of three.

Patients in the TCA group received a total of 23 treatments with 32

gauge acupuncture needles inserted to a conventional depth at 9

standard points that traversed the area of knee pain (Rheumatol

1999;38:346-54); guide tubes were tapped at 2 sham points on the

abdomen. Patients in the SA group had needles inserted in the 2 sham

points on the abdomen and guide tubes tapped onto the surface at the 9

identical standard points. The acupuncturists were licensed and trained

and certified by one of the authors. Patients in the education group

received the Arthritis Self-Help Course over 12 weekly 2-hour group

sessions. All patients were advised to continue background analgesic or

antiinflammatory therapy. The primary outcomes were change in the WOMAC

pain and function scales over time. Research assistants who collected

outcomes data, participants who received TCA or SA and statisticians

were masked to treatment allocation. An intent-to-treat analysis using

a mixed longitudinal model was performed; statistical comparison was

made between the TCA and SA groups only.

 

Results: At entry, the mean [sD] WOMAC pain and function subscale

scores were 8.94 [3.50] and 31.7 [12.0] (ranges of 0-20 and 0-68,

respectively); there were no differences by treatment group. There was

a significant time*group interaction for improvement in both the WOMAC

pain and function subscales for the patients who received TCA vs SA;

the mean changes from baseline by group at weeks 4, 8, 14 and 26 are

shown in the Table. These results were confirmed in analyses limited to

completers, and using LOCF to impute missing data (data not shown). No

serious treatment-related adverse events occurred during the trial.

 

Conclusions: These data confirm that TCA is effective as an adjunctive

therapy for reducing pain and improving function in patients with

symptomatic knee OA.

 

Change from baseline in outcome measures (WOMAC Pain/Function) by

treatment group

Week No TCA SA P-value

4 TCA 173 Pain -2.22 (0.24) ) Pain -1.98 (0.25) Pain 0.48

SA 163 Funct -7.56 (0.78 Funct -5.90 (0.66) Funct 0.15

8 TCA 169 Pain -3.15 (0.29) Pain -2.66 (0.26) Pain 0.18

SA 161 Funct -10.77 (0.90) Funct -7.84 (0.76) Funct 0.01

14 TCA 158 Pain -3.63 (0.31) Pain -2.68 (0.33) Pain 0.02

SA 157 Funct -12.18 (0.96) Funct -9.40 (0.94) Funct 0.04

26 TCA 142 Pain -3.79 (0.33) Pain -2.92 (0.30) Pain 0.003

SA 141 Funct -12.42 (1.12) Funct -9.87 (0.93) Funct 0.009

 

 

 

 

 

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