Clinical Efficacy of Acupuncture for the Treatment of Rheumatoid Arthritis: Meta-Analysis of Randomized Clinical Trials

Abstract

Objective. Acupuncture has been used by rehabilitation specialists as an adjunctive treatment for the symptomatic treatment of rheumatoid arthritis (RA). This meta-analysis aims to evaluate the efficacy of acupuncture in treating patients with RA. Methods. A comprehensive search was conducted in CBM, CNKI, PubMed, CENTRAL, Web of Science, and Embase from their inception up to March 2022. All randomized controlled trials (RCTs) without the language restriction, concerning the patients with RA treated with acupuncture, were included. Two reviewers independently assessed the risk of bias with the Cochrane Risk of Bias Assessment tool. Weight mean difference (MD) and 95% CI were calculated, and data were pooled with random effects model. Results. A total of eleven RCTs involving 796 patients with RA met the established inclusion criteria. This systematic review indicated the efficacy of acupuncture as an adjunctive treatment for patients with RA. Invasive acupuncture could reduce significantly in pain (MD = -1.00, 95% CI: −1.96 to −0.05, $P=0.040$ ), health assessment questionnaire (HAQ, MD = −0.20, 95% CI: −0.30 to −0.11, $P<0.001$ ), physician global assessment (PhGA, MD = −0.98, 95% CI: −1.23 to −0.72, $P<0.001$ ), tender joint count (TJC, MD = −1.24, 95% CI: −2.11 to −0.37, $P=0.005$ ), C-reactive protein (CRP, MD = −1.81, 95% CI: −3.32 to −0.29, $P=0.019$ ), and erythrocyte sedimentation rate (ESR, MD = −3.03, 95% CI: −5.80 to −0.26, $P=0.032$ ), while compared to control group. Laser acupuncture could reduce HAQ (MD = −0.15, 95% CI: −0.28 to −0.01, $P=0.034$ ), the RA quality of life questionnaire (RAQoL, MD = −2.32, 95% CI: −4.40 to −0.25, $P=0.028$ ), CRP (MD = −35.24, 95% CI: −36.49 to −33.99, $P<0.001$ ), and interleukin-6 (IL-6, MD = −29.63, 95% CI: −49.34 to −9.92, $P=0.003$ ), while compared to control group. No adverse events associated with acupuncture were reported. Conclusion. Available evidence suggests that acupuncture is beneficial for relieving pain and ameliorating quality of life and health index in patients with RA; thereby, it should be available as an adjunctive nonpharmacological treatment in rehabilitation programmes.