True acupuncture treatment showed a
statistically significant reduction in joint pain at 6 weeks, compared with
sham acupuncture or with waitlist control, among postmenopausal women with
early-stage breast cancer and aromatase inhibitor–related arthralgias. The results
of clinical study were recently published in the Journal of the American Medical
Association.
Despite the
well-proven efficacy of aromatase inhibitors (AIs), namely anastrozole,
letrozole and exemestane for the treatment of hormone-sensitive breast cancer, some
patients suffer from side effects or even stop treatment early due to
undesirable toxicities. The most common side effects of AIs are hot
flashes, vaginal dryness, musculoskeletal pain and headache etc.
Acupuncture is
utilized to treat pain-related conditions including cancer related pain. However,
the controversial reports indicated its effect is the same as the sham acupuncture.
This multicenter randomized blinded sham- and
waitlist controlled clinical trial was conducted to evaluate the effect of
acupuncture on joint pain related to aromatase inhibitors among women with
early-stage breast cancer. Study participants were randomized 2:1:1 to the true
acupuncture group, the sham acupuncture group, or the waitlist control group. Briefly,
both true acupuncture and sham acupuncture consisted of twelve 30- to 45- minute
sessions administered over a period of 6 weeks (2 per week) followed by 1
session per week for 6 weeks.
The results showed that the mean observed the Brief Pain Inventory Worst
Pain (BPI-WP item, score range, 0-10; higher scores indicate greater pain) score was 2.05 points lower (reduced pain) at 6 weeks in
the true acupuncture group, 1.07 points lower in the sham acupuncture group,
and 0.99 points lower for the waitlist control group, with differences in
adjusted 6-week mean BPI-WP scores between true acupuncture vs sham acupuncture
of 0.92 points(95% CI,0.20-1.65; P = .01) and between true acupuncture vs
waitlist control of 0.96 points (95% CI, 0.24-1.67; P = .01), in comparison
with baseline. Patients randomized to the true acupuncture group had
statistically significant improved symptom scores compared with those
randomized to the sham acupuncture and waitlist control groups at 6 weeks
according to BPI average pain, pain severity, and worst stiffness, and according
to the modified assessment and quantification of chronic rheumatic affections
of the hands (M-SACRAH), Western Ontario and McMaster Universities Arthritis
Index (WOMAC) measures. Bruising was the most common adverse incident reported
for those receiving true acupuncture or sham acupuncture.
This is the first
large multicenter trial to investigate the effect of acupuncture in treating
AI-induced joint symptoms in breast cancer patients. The data clearly showed
that true acupuncture statistically and significantly outperformed the sham
acupuncture in joint pain relief of those patients.
Reference
DL. Hershman et al., Effect
of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to
Aromatase Inhibitors Among Women With Early-Stage Breast Cancer A Randomized
Clinical Trial. JAMA. 2018;320(2):167-176. doi:10.1001/jama.2018.8907.https://www.ncbi.nlm.nih.gov/pubmed/29998338
