Acupuncture Benefits Aromatase Inhibitor-Related Joint Pain

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In this trial, postmenopausal patients with breast cancer were randomly assigned to receive true acupuncture, sham acupuncture, or waitlist control.
In this trial, postmenopausal patients with breast cancer were randomly assigned to receive true acupuncture, sham acupuncture, or waitlist control.

Acupuncture may represent an effective adjuvant therapy in the management of joint pain associated with aromatase inhibitor treatment in postmenopausal women with breast cancer, according to results from a multicenter trial presented at the 2017 San Antonio Breast Cancer Symposium held December 5-9.

For this trial, investigators randomly assigned postmenopausal patients with breast cancer to receive true acupuncture (TA; n=110), sham acupuncture (SA; n=59), or waitlist control (WC; n=57). For the TA and SA protocols, interventions were administered over a 12-week period, with 12 sessions over 6 weeks followed by 1 session/week for an additional 6 weeks. Primary end point used in this study was the change in the Brief Pain Inventory worst pain (BPI-WP) score at 6 weeks.

The BPI-WP scores were lower at 6 weeks in the TA vs SA group (95% CI, 0.20-1.65; P =.01) and in the TA vs WC group (0.96 point difference; 95% CI, 0.24-1.67; P =.01). A greater percentage of patients receiving TA experienced a clinical reduction in BPI-WP scores vs patients receiving SA and WC (58% vs 33% and 31%, respectively).

In addition, patients receiving TA experienced greater improvement at 6 weeks in average pain (P =.04), pain interference (P =.02), pain severity (P =.05), and worst stiffness (P =.02), compared with the SA group. Also, participants in the TA group experienced greater symptom improvement at 6 and 12 weeks as assessed with the Modified Score for the Assessment of Chronic Rheumatoid Affections of the Hands and the Western Ontario and McMaster Universities Osteoarthritis Index (P <.05). Researchers observed significantly more Grade 1 bruising events in the TA vs the SA group (47% vs 25%, respectively; P =.01).

According to a published statement by said Dawn L. Hershman, MD, the leader of the Breast Cancer Program at the Herbert Irving Comprehensive Cancer Center at New York Presbyterian/Columbia University Medical Center, “We hope that these data will not only encourage health care practitioners to discuss acupuncture as a complementary therapy for patients receiving aromatase inhibitors, but that they will also enhance payers' willingness to reimburse these patients for acupuncture.”

Reference

1. Hershman DL, Unger JM, Greenlee H, et al. Randomized blinded sham- and waitlist-controlled trial of acupuncture for joint symptoms related to aromatase inhibitors in women with early stage breast cancer. Presented at: San Antonio Breast Cancer Symposium 2017. December 5-9, 2017, San Antonio, Texas. Abstract S1200.    

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