Feasibility Trial of Electroacupuncture for Aromatase Inhibitor—Related Arthralgia in Breast Cancer Survivors

Abstract

Background Arthralgia affects postmenopausal women receiving aromatase inhibitors (AI) for breast cancer. Given the existing evidence for electro-acupuncture (EA) for treatment of osteoarthritis in the general population, this study aims to establish the feasibility of studying EA for treating AI-related arthralgia. Patients and Methods Postmenopausal women with stage I-III breast cancer who reported AI-related arthralgia were enrolled in a single arm feasibility trial. EA was provided twice a week for two weeks followed by six weekly treatments. The protocol was based on Chinese medicine diagnosis of “Bi” syndrome with electro-stimulation of needles around the painful joint(s). Pain severity of the modified Brief Pain Inventory was used as the primary outcome. Joint stiffness, Joint interference, and Patient Global Impression of Change (PGIC) were secondary outcomes. Paired-t tests were used for analysis. Results Twelve women were enrolled and all provided data for analysis. From baseline to the end of intervention, patients reported reduction in pain severity (5.3 to 1.9), stiffness (6.9 to 2.4), and joint symptom interference (4.7 to 0.8), all P<0.001; 11/12 considered joint symptoms “very much better” based on PGIC. Subjects also reported significant decrease in fatigue (4.4 to 1.9, p=0.005) and anxiety (7.1 to 4.8, p=0.01). No infection or development or worsening of lymphedema was observed. Conclusion Preliminary data establishes the feasibility of recruitment and acceptance as well as promising preliminary safety and effectiveness. A randomized controlled trial is warranted to establish the efficacy of EA for AI-related arthralgia in breast cancer survivors.

Acupuncture in the Oncology Setting: Clinical Trial Update

“…Of 12 enrolled and analyzable women, reduction in pain severity also measured by the BPI-SF was found (P < 0.001). Moreover, Mao et al [14] administered the Patient Global Impression of Change (PGIC) as an additional secondary outcome and found significant reduction in scores after 6 weeks of treatment with electro acupuncture.…”

Management of aromatase inhibitor induced musculoskeletal symptoms in postmenopausal early Breast cancer: A systematic review and meta-analysis

“…There were five RCTs, three of which investigated the use of acupuncture (31,32,34) and two of which investigated the use of electro-acupuncture (28,29). There was also one single-arm pilot study, which investigated the use of electroacupuncture (42). Of the RCTs, three studies investigated true acupuncture/electro-acupuncture versus sham acupuncture (28,31,32); one study had three arms consisting of true electro-acupuncture, sham electro-acupuncture and a waitlist control (29) and one trial was a crossover design, investigating acupuncture versus observation, then crossover after six weeks (34).…”

Expectancy in Real and Sham Electroacupuncture: Does Believing Make It So?

“…The EA regimen used a manualized protocol, which was formulated on the basis of the "Bi Syndrome" in Traditional Chinese Medicine, and was developed via our feasibility trial (14). The acupuncturists inserted and manipulated the needles (30 or 40 mm, and 0.25 mm gauge; Seirin-America, Inc, Weymouth, MA) until the "de qi" sensation was achieved.…”