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Randomized Controlled Trial
. 2014 Jan;50(2):267-76.
doi: 10.1016/j.ejca.2013.09.022. Epub 2013 Oct 24.

A randomised trial of electro-acupuncture for arthralgia related to aromatase inhibitor use

Jun J Mao  1 , Sharon X Xie  2 , John T Farrar  3 , Carrie T Stricker  4 , Marjorie A Bowman  5 , Deborah Bruner  6 , Angela DeMichele  3
Affiliations
Randomized Controlled Trial

A randomised trial of electro-acupuncture for arthralgia related to aromatase inhibitor use

Jun J Mao et al. Eur J Cancer. 2014 Jan.

Abstract

Background: Arthralgia is a common and debilitating side-effect experienced by breast cancer patients receiving aromatase inhibitors (AIs) and often results in premature drug discontinuation.

Methods: We conducted a randomised 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 10 EA/SA treatments over 8 weeks using a manualised 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 end-point 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.

Findings: 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 versus -0.2, p=0.0004) and at Week 12 (-2.4 versus -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 versus 0.2, p=0.0006) and Week 12 (-2.1 versus -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.

Interpretations: 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.

Trial registration: ClinicalTrials.gov NCT01013337.

Keywords: Acupuncture; Adverse effects; Aromatase inhibitors; Breast neoplasm; Clinical trial; Joint pain; Musculoskeletal.

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Conflict of interest statement

Conflicts of Interests

Dr. Mao has consulted for Pfizer on issues unrelated to aromatase inhibitors. Dr. Farrar has consulted for Pfizer and AstaZeneca on issues that are unrelated to aromatase inhibitors. The other co-authors had no conflict of interest to declare.

Figures

Figure 1
Figure 1. Screening, Randomization and Completion of 8-Week and 12-Week Evaluations
Figure 2
Figure 2. Mean Change in Pain Severity and Pain-related Interference at 8 and 12 Weeks from Baseline, According to Treatment Group
Change in Brief Pain Inventory (BPI) severity and interference scores from baseline are shown for electro-acupuncture (EA), sham acupuncture (SA), and waitlist control (WLC) groups.
Figure 3
Figure 3. Mean Changes in Secondary Outcomes at 8 and 12 Weeks from Baseline, According to Treatment Group
Changes in outcome scores from baseline are shown for electro-acupuncture (EA), sham acupuncture (SA), and waitlist control (WLC) groups.
See this image and copyright information in PMC

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References

    1. Burstein HJ, Winer EP. Aromatase inhibitors and arthralgias: a new frontier in symptom management for breast cancer survivors. J Clin Oncol. 2007 Sep 1;25(25):3797–3799. - PubMed
    1. Mao JJ, Stricker C, Bruner D, Xie S, Bowman MA, Farrar JT, et al. Patterns and risk factors associated with aromatase inhibitor-related arthralgia among breast cancer survivors. Cancer. 2009 Aug 15;115(16):3631–3639. - PMC - PubMed
    1. Mao JJ, Chung A, Benton A, Hill S, Ungar L, Leonard C, et al. Online discussion of drug side effects and discontinuation among breast cancer survivors. Pharmacoepidemiology and Drug Safety. 2013 - PMC - PubMed
    1. Henry NL, Azzouz F, Desta Z, Li L, Nguyen AT, Lemler S, et al. Predictors of aromatase inhibitor discontinuation as a result of treatment-emergent symptoms in early-stage breast cancer. J Clin Oncol. 2012 Mar 20;30(9):936–942. - PMC - PubMed
    1. Hershman DL, Shao T, Kushi LH, Buono D, Tsai WY, Fehrenbacher L, et al. Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer. Breast Cancer Res Treat. 2011 Apr;126(2):529–537. - PMC - PubMed

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