Acupuncture May Reduce Itching in Atopic Dermatitis: Study

Atopic dermatitis is a chronic inflammatory skin disease that is characterized by recurrent episodes of eczema, severe itching, and poor quality of life. However, many patients turn to complementary and alternative treatments such as acupuncture (ACU) and osteopathic medicine (OM) despite the lack of high-quality evidence for their efficacy. In this three-armed, single-center, randomized controlled open-label exploratory trial, the researchers assessed whether the addition of ACU or OM to standard care would offer any benefit over standard care alone.

Patients with AD often suffer from intractable itching and exacerbations, necessitating the frequent use of topical corticosteroids (TCS). This was a three-armed randomized controlled open-label exploratory trial performed in a single center. Patients with AD were randomly assigned to receive:

• Acupuncture (ACU) in addition to routine care

• Osteopathic medicine (OM), in addition to routine care

• No additional study treatment (control group; CG) in addition to routine care

• A total of 121 patients were randomly assigned, including 92 women and 29 men. The mean ± SD age was 31.4 ± 10.5 years.

• Data were collected for 12 weeks.

The primary endpoints were:

• Disease severity as measured by SCORing Atopic Dermatitis (SCORAD)

• Intensity of itching as measured by the visual analogue scale (VAS)

• Use of topical corticosteroids (TCS) for 7 days

• Cost-effectiveness

Data were analyzed using analysis of covariance, adjusting for baseline values and TCS use.

Key findings

• Adjusted mean SCORAD scores (95% CI) at 12 weeks were 22.3 (18.3–26.3) in the ACU group, 26.4 (22.6–30.2) in the OM group, and 23.7 (19.9–27.5) in the control group.

• The difference between groups was not statistically significant (P = 0.32), and there was no meaningful improvement in overall disease severity with either treatment.

• However, there were significant differences in itching intensity.

• Adjusted mean VAS itching scores (95% CI) were 27.9 (19.5–36.4) for ACU, 35.0 (26.9–43.0) for OM, and 42.3 (34.7–50.0) for controls.

• The reduction in intensity of itching was statistically significant (P < 0.05), and the data indicate that the use of acupuncture may provide significant relief from itching.

• For the use of topical corticosteroids over 7 days, adjusted means (95% CI) were 2.3 (0.8-3.9) for ACU, 1.9 (0.4-3.5) for OM, and 4.3 (2.6-6.0) for controls.

• Although both ACU and OM tended to reduce TCS use compared to controls, this was not statistically significant (P = 0.10).

Although there were no significant differences in the severity of the disease, the intensity of itching in patients with atopic dermatitis may be reduced by acupuncture. Both acupuncture and osteopathic medicine had a tendency to decrease the use of topical corticosteroids, but neither modality was cost-effective compared with standard care. The results of this study indicate that acupuncture may be beneficial in the symptomatic treatment of itching in AD, but further studies are required to assess its long-term efficacy.

Reference:

Rotter, G., Ahnert, M. W., Geue, A. V., Icke, K., Binting, S., Tissen-Diabaté, T., Roll, S., Ortiz, M., Reinhold, T., Kass, B., Staab, D., Pfab, F., Willich, S. N., & Brinkhaus, B. (2022). Acupuncture and osteopathic medicine for atopic dermatitis: a three-armed, randomized controlled explorative clinical trial. Clinical and Experimental Dermatology, 47(12), 2166–2175. https://doi.org/10.1111/ced.15340