Revisiting the role of acupuncture in ankylosing spondylitis :- Medznat

The therapeutic potential of acupuncture for ankylosing spondylitis (AS) remains under debate, limited by methodological simplicity and variability in acupuncture application.

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Key take away

Acupuncture is a valuable complementary therapy for ankylosing spondylitis, markedly improving pain, spinal function, quality of life, inflammatory markers, and treatment effectiveness.

Background

The therapeutic potential of acupuncture for ankylosing spondylitis (AS) remains under debate, limited by methodological simplicity and variability in acupuncture application. Existing studies often lack nuanced intervention protocols and robust outcome measures.

This systematic review and meta-analysis sought to re-examine acupuncture’s role in AS care by integrating rigorously selected, high-quality studies—seeking to position acupuncture as a viable, non-pharmacological adjunct.

Method

A comprehensive search across 7 databases (up to March 31, 2023) identified randomized controlled trials (RCTs) with PEDro scores ≥6 that compared traditional acupuncture—alone or alongside conventional therapies—with standard care in AS. Study quality was appraised via PEDro and ROB2, and meta-analysis was carried out via STATA.

Result

Overall, 21 RCTs encompassing 1,884 volunteers were analyzed. Compared to controls, acupuncture remarkably boosted treatment effectiveness in both Western medicine (risk ratio [RR] = 1.223) and traditional Chinese medicine settings (RR = 1.175). Patients reported noticeably less pain (visual analogue scale [VAS]; SMD = −0.666), and showed meaningful gains in spinal health, with marked improvements in functional capacity (Bath Ankylosing Spondylitis Functional Index [BASFI]; standardized mean difference [SMD] = −0.827), disease activity (SMD = −1.069), and mobility (SMD = −0.699), all with P < 0.001.

Beyond physical function, acupuncture appeared to enhance quality of life (SMD = −0.619), while also calming biological markers of inflammation—C-reactive protein (SMD = −0.980) and erythrocyte sedimentation rate (SMD = −0.701)—again, all highly significant (P < 0.001).

Conclusion

Despite the overall high risk of bias, findings from high-quality studies suggest that acupuncture is an effective complementary and alternative treatment for AS. It may help alleviate pain, enhance spinal function, boost quality of life, and lessen inflammation.