Mao, J.J., Xie, S.X., Farrar, J.T., Stricker, C.T., Bowman, M.A., Bruner, D., & DeMichele, A. (2014). A randomised trial of electro-acupuncture for arthralgia related to aromatase inhibitor use. European Journal of Cancer, 50, 267–276.

To test the hypothesis that electroacupuncture (EA) would improve function and reduce arthralgia compared to usual care

Patients were randomized to wait-list control, EA, or sham acupuncture (SA) groups. Acupuncture was given twice a week for two weeks, then weekly, for a total of 10 treatments over eight weeks. SA treatment frequency and duration were the same as for EA. Study assessments were done at baseline, after eight weeks, and at week 12.

• N = 36
• MEAN AGE = 59.67 years
• FEMALES: 100%
• KEY DISEASE CHARACTERISTICS: All received aromatase inhibitors ranging from 19.5–31.1 months across groups. Duration of joint pain ranged from 43.4–62.9 on average. Duration was highly variable across groups.

• SITE: Single site 
• SETTING TYPE: Outpatient 
• LOCATION: Pennsylvania

• PHASE OF CARE: Active antitumor treatment

• Double-blind, placebo-controlled RCT

• Brief Pain Inventory (BPI)
• Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
• Quick Disability of Arm Shoulder Hand (DASH)
• Physical Performance Test (PPT)

At week 8  and week 12, the EA group had a greater reduction in pain severity and pain interference compared to the wait-list control group (p < .001). The EA group also had greater improvement in DASH scores and outcomes, as measured by the WOMAC index compared to controls. The SA group also had a significantly greater reduction in pain severity and interference compared to controls at week 8 and week 12 (p < .005). No significant differences were seen between the SA and EA groups.

EA and SA were associated with reduction in arthralgia pain severity and interference and improvement in joint disability measures.

• Small sample (less than 100)
• Subject withdrawals 10% ore more
• No information is provided regarding pain medication use.
• Withdrawals were high, suggesting that the intervention may not be acceptable or practical for many patients.

Findings suggest that EA and placebo acupuncture resulted in reduced pain from arthralgia in patients receiving aromatase inhibitors. Although this study was well designed, the sample size was small, and a substantial number of participants dropped out. Placebo effects of acupuncture or SA may help to alleviate arthralgia pain in these patients, and this approach may be acceptable or preferred by some patients.