A Randomized Trial of Electro-acupuncture for Arthralgia related to Aromatase Inhibitor Use
Identifieur interne : 003958 ( Main/Exploration ); précédent : 003957; suivant : 003959A Randomized Trial of Electro-acupuncture for Arthralgia related to Aromatase Inhibitor Use
Auteurs : Jun J. Mao [États-Unis] ; Sharon X. Xie [États-Unis] ; John T. Farrar [États-Unis] ; Carrie T. Stricker [États-Unis] ; Marjorie A. Bowman ; Deborah Bruner ; Angela Demichele [États-Unis]Source :
- European journal of cancer (Oxford, England : 1990) [ 0959-8049 ] ; 2013.
Abstract
Arthralgia is a common and debilitating side effect experienced by breast cancer patients receiving aromatase inhibitors (AIs) and often results in premature drug discontinuation.
We conducted a randomized controlled trial of electro-acupuncture (EA) as compared to waitlist control (WLC) and sham acupuncture (SA) in postmenopausal women with breast cancer who self-reported arthralgia attributable to AIs. Acupuncturists performed ten EA/SA treatments over eight weeks using a manualized protocol with 2 Hz electro-stimulation delivered by a TENS unit. Acupuncturists administered SA using Streitberger (non-penetrating) needles at non-traditional acupuncture points without electro-stimulation. The primary endpoint was pain severity by Brief Pain Inventory (BPI) between EA and WLC at Week 8; durability of response at Week 12 and comparison of EA to SA were secondary aims.
Of the 67 randomly assigned patients, mean reduction in pain severity was greater in the EA group than in the WLC group at Week 8 (−2.2 vs. −0.2, p=0.0004) and at Week 12 (−2.4 vs. −0.2, p<0.0001). Pain-related interference measured by BPI also improved in the EA group compared to the WLC group at both Week 8 (−2.0 vs. 0.2, p=0.0006) and Week 12 (−2.1 vs. −0.1, p=0.0034). SA produced a magnitude of change in pain severity and pain-related interference at Week 8 (−2.3, −1.5 respectively) and Week 12 (−1.7, −1.3 respectively) similar to that of EA. Participants in both EA and SA groups reported few minor adverse events.
Compared to usual care, EA produced clinically important and durable improvement in arthralgia related to AIs in breast cancer patients, and SA had a similar effect. Both EA and SA were safe.
Url:
DOI: 10.1016/j.ejca.2013.09.022
PubMed: 24210070
PubMed Central: 3972040
Affiliations:
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Mao</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania</wicri:cityArea></affiliation></author><author><name sortKey="Xie, Sharon X" sort="Xie, Sharon X" uniqKey="Xie S" first="Sharon X." last="Xie">Sharon X. 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Farrar</name><affiliation wicri:level="2"><nlm:aff id="A2">Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania</wicri:cityArea></affiliation></author><author><name sortKey="Stricker, Carrie T" sort="Stricker, Carrie T" uniqKey="Stricker C" first="Carrie T." last="Stricker">Carrie T. Stricker</name><affiliation wicri:level="2"><nlm:aff id="A3">Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania</wicri:cityArea></affiliation></author><author><name sortKey="Bowman, Marjorie A" sort="Bowman, Marjorie A" uniqKey="Bowman M" first="Marjorie A." last="Bowman">Marjorie A. Bowman</name><affiliation><nlm:aff id="A4">Wright State University School of Medicine</nlm:aff></affiliation></author><author><name sortKey="Bruner, Deborah" sort="Bruner, Deborah" uniqKey="Bruner D" first="Deborah" last="Bruner">Deborah Bruner</name><affiliation><nlm:aff id="A5">Emory University School of Nursing</nlm:aff></affiliation></author><author><name sortKey="Demichele, Angela" sort="Demichele, Angela" uniqKey="Demichele A" first="Angela" last="Demichele">Angela Demichele</name><affiliation wicri:level="2"><nlm:aff id="A2">Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania</wicri:cityArea></affiliation></author></analytic><series><title level="j">European journal of cancer (Oxford, England : 1990)</title><idno type="ISSN">0959-8049</idno><idno type="eISSN">1879-0852</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">Arthralgia is a common and debilitating side effect experienced by breast cancer patients receiving aromatase inhibitors (AIs) and often results in premature drug discontinuation.</p></sec><sec id="S2"><title>Methods</title><p id="P2">We conducted a randomized controlled trial of electro-acupuncture (EA) as compared to waitlist control (WLC) and sham acupuncture (SA) in postmenopausal women with breast cancer who self-reported arthralgia attributable to AIs. Acupuncturists performed ten EA/SA treatments over eight weeks using a manualized protocol with 2 Hz electro-stimulation delivered by a TENS unit. Acupuncturists administered SA using Streitberger (non-penetrating) needles at non-traditional acupuncture points without electro-stimulation. The primary endpoint was pain severity by Brief Pain Inventory (BPI) between EA and WLC at Week 8; durability of response at Week 12 and comparison of EA to SA were secondary aims.</p></sec><sec id="S3"><title>Findings</title><p id="P3">Of the 67 randomly assigned patients, mean reduction in pain severity was greater in the EA group than in the WLC group at Week 8 (−2.2 vs. −0.2, p=0.0004) and at Week 12 (−2.4 vs. −0.2, p<0.0001). Pain-related interference measured by BPI also improved in the EA group compared to the WLC group at both Week 8 (−2.0 vs. 0.2, p=0.0006) and Week 12 (−2.1 vs. −0.1, p=0.0034). SA produced a magnitude of change in pain severity and pain-related interference at Week 8 (−2.3, −1.5 respectively) and Week 12 (−1.7, −1.3 respectively) similar to that of EA. Participants in both EA and SA groups reported few minor adverse events.</p></sec><sec id="S4"><title>Interpretations</title><p id="P4">Compared to usual care, EA produced clinically important and durable improvement in arthralgia related to AIs in breast cancer patients, and SA had a similar effect. Both EA and SA were safe.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region></list><tree><noCountry><name sortKey="Bowman, Marjorie A" sort="Bowman, Marjorie A" uniqKey="Bowman M" first="Marjorie A." last="Bowman">Marjorie A. Bowman</name><name sortKey="Bruner, Deborah" sort="Bruner, Deborah" uniqKey="Bruner D" first="Deborah" last="Bruner">Deborah Bruner</name></noCountry><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Mao, Jun J" sort="Mao, Jun J" uniqKey="Mao J" first="Jun J." last="Mao">Jun J. Mao</name></region><name sortKey="Demichele, Angela" sort="Demichele, Angela" uniqKey="Demichele A" first="Angela" last="Demichele">Angela Demichele</name><name sortKey="Demichele, Angela" sort="Demichele, Angela" uniqKey="Demichele A" first="Angela" last="Demichele">Angela Demichele</name><name sortKey="Farrar, John T" sort="Farrar, John T" uniqKey="Farrar J" first="John T." last="Farrar">John T. Farrar</name><name sortKey="Farrar, John T" sort="Farrar, John T" uniqKey="Farrar J" first="John T." last="Farrar">John T. Farrar</name><name sortKey="Mao, Jun J" sort="Mao, Jun J" uniqKey="Mao J" first="Jun J." last="Mao">Jun J. Mao</name><name sortKey="Mao, Jun J" sort="Mao, Jun J" uniqKey="Mao J" first="Jun J." last="Mao">Jun J. Mao</name><name sortKey="Stricker, Carrie T" sort="Stricker, Carrie T" uniqKey="Stricker C" first="Carrie T." last="Stricker">Carrie T. Stricker</name><name sortKey="Xie, Sharon X" sort="Xie, Sharon X" uniqKey="Xie S" first="Sharon X." last="Xie">Sharon X. Xie</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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