Acupuncture Linked to Reduced Joint Pain for Up to a Year

Comparison of Acupuncture vs Sham Acupuncture or Waiting List Control in the Treatment of Aromatase Inhibitor–Related Joint Pain – A Randomized Clinical Trial

Aromatase inhibitors (AIs) have proven efficacy for the treatment of hormone-sensitive breast cancer. They do this by preventing an enzyme in fat tissue (aromatase) from changing other hormones into estrogen.  

About 80% of breast cancers are estrogen-receptor positive and arthralgias (pain and stiffness) contribute to nonadherence with therapy for more than 50% of patients.

In this multicenter randomized clinical trial of 226 women with early-stage breast cancer, patients in the true acupuncture group who received 12 weeks of acupuncture, compared with those in the sham acupuncture group or the waiting list control group, had statistically significant reductions in joint pain scores at 52 weeks.

“It’s reassuring that the effects can be maintained without continuous need for treatments,” lead author Dawn L. Hershman, MD, professor of medicine and epidemiology, Columbia University Medical Center, New York City

Hershman added that clinicians should “offer this as an option for patients on AI therapy who complain of significant joint pain and to advocate for payers to cover the costs.”

Both pharmacologic (duloxetine, testosterone, ω3 fatty acids, and vitamin D20) and nonpharmacologic interventions (exercise) have been studied to treat AI-associated arthralgias with mixed results. Most of these trials did not assess or did not find long-term benefits. In addition, the 4 prior studies of acupuncture for AI arthralgias did not evaluate the maintenance or durability of effect. The results from this most recent study support findings from prior studies of the sustained effects of acupuncture. Mechanisms that may underlie these effects have been proposed, including the suggestion that acupuncture works by stimulating the vagal-adrenal axis and reducing inflammation.

Acupuncture is appealing to some patients because the adverse effects are generally limited compared with medications; however, this treatment is not covered by many insurance plans or the NHS.

References:

https://www.medscape.com/viewarticle/984171?src=WNL_mdpls_221118_mscpedit_wir&uac=104620AJ&spon=17&impID=4880322&fbclid=IwAR0JZ9RiAt56JARtyOkQy0_fuKTwSspwCZjITWElJFILlM_qCcAhOKZKTPI

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798317?utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamanetworkopen&utm_content=wklyforyou&utm_term=111122

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