Different modalities of accupuncture reduce chronic pain in cancer survivors: JAMA
USA: Electroacupuncture and auricular acupuncture may help in greater reduction of chronic pain versus usual care in cancer survivors with chronic musculoskeletal pain, finds a recent study in the journal JAMA Oncology. Further, auricular acupuncture was not found to be noninferior to electroacupuncture and patients who received it experienced more adverse effects.
In the current scenario of opioid crisis, challenges arise for cancer pain management. The use of acupuncture is shown to provide clinical benefits for chronic nonmalignant pain, but its effectiveness in cancer survivors remains uncertain. Jun J. Mao, Memorial Sloan Kettering Cancer Center, New York, New York, and colleagues, therefore, aimed to determine the effectiveness of electroacupuncture or auricular acupuncture for chronic musculoskeletal pain in cancer survivors.
For the purpose, the researchers performed Personalized Electroacupuncture vs Auricular Acupuncture Comparativeness Effectiveness (PEACE) trial. The trial was a randomized clinical trial that was conducted from March 2017 to October 2019 across an urban academic cancer center and 5 suburban sites in New York and New Jersey.
The study included 360 adults with a prior cancer diagnosis but no current evidence of disease, reported musculoskeletal pain for at least 3 months, and self-reported pain intensity on the Brief Pain Inventory (BPI) ranging from 0 (no pain) to 10 (worst pain imaginable).
They were randomized in a ratio of 2:2:1 to receive electroacupuncture (n = 145), auricular acupuncture (n = 143), or usual care (n = 72). Intervention groups received 10 weekly sessions of electroacupuncture or auricular acupuncture. Ten acupuncture sessions were offered to the usual care group from weeks 12 through 24.
Key findings of the study include:
- Among 360 cancer survivors, 340 (94.4%) completed the primary end point.
- Compared with usual care, electroacupuncture reduced pain severity by 1.9 points and auricular acupuncture reduced by 1.6 points from baseline to week 12.
- Noninferiority of auricular acupuncture to electroacupuncture was not demonstrated.
- Adverse events were mild; 15 of 143 (10.5%) patients receiving auricular acupuncture and 1 of 145 (0.7%) patients receiving electroacupuncture discontinued treatments due to adverse events.
"In this randomized clinical trial among cancer survivors with chronic musculoskeletal pain, electroacupuncture and auricular acupuncture produced greater pain reduction than usual care," wrote the authors. 'However, auricular acupuncture did not demonstrate noninferiority to electroacupuncture, and patients receiving it had more adverse events."
The study titled, "Effectiveness of Electroacupuncture or Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain Among Cancer Survivors: The PEACE Randomized Clinical Trial,' is published in the journal JAMA Oncology.