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Efficacy of acupuncture in fibromyalgia syndrome; A systematic review with a meta-analysis of controlled clinical trials
Rheumatology, 01/28/2010
Langhorst J et al. – The goal of this review was to systematically review the efficacy of acupuncture in FMS. A small analgesic effect of acupuncture was present, which, however, was not clearly distinguishable from bias. Thus, acupuncture cannot be recommended for the management of FMS.
Methods- MEDLINE, PsychInfo, EMBASE, CAMBASE and the Cochrane Library were screened (through July 2009)
- Reference sections of original studies and systematic reviews for randomized controlled trials (RCTs) on acupuncture in FMS were searched
- 7 RCTs with a median treatment time of 9 (range 6–25) sessions and 385 patients were included
- Outcomes of interest were key symptoms of FMS, namely pain, fatigue, sleep disturbances, reduced physical function and side effects at post-treatment
- Follow-up of 2 RCTs with a median follow-up of 26 weeks was available
- Standardized mean differences (SMDs) comparing verum and control acupuncture calculated
- Strong evidence for reduction of pain (SMD –0.25; 95% CI –0.49, –0.02; P = 0.04) was found at post-treatment
- No evidence for reduction of fatigue and sleep disturbances, or improvement of physical function at post-treatment
- Subgroup analyses resulted in moderate evidence for significant and small reduction of pain at post-treatment in studies with electro-stimulation and individualized acupuncture
- Stratifying the type of controls (penetrating vs non-penetrating control acupuncture) did not change results
- Significant reduction of pain only present in studies with risk of bias
- Side effects inconsistently reported