- Acupuncture has higher efficacy than drug therapy and fewer adverse events (AEs) in patients with diarrhea-predominant irritable bowel syndrome (IBS-D), according to a network meta-analysis (NMA).
Why this matters
- Acupuncture may be considered the first-line therapy for IBS-D.
- NMA of 29 randomized controlled trials (RCTs) (n=9369) that met eligibility criteria after search that included PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and Chinese Biomedical Database.
- Funding: None disclosed.
- NMA analysis of efficacy by cumulative probability (P) of treatment effect showed this highest to lowest ranking:
- acupuncture (P=.977);
- sham acupuncture (P=.90);
- pinaverium bromide (P=.69);
- alosetron (P=.35) and eluxadoline (P=.3);
- ramosetron (P=.31); and
- rifaximin (P=.81).
- Ranking of AEs from most severe to least severe:
- ramosetron and pinaverium bromide;
- sham acupuncture; and
- The most common acupuncture points were ST25, ST36, ST37, SP6, GV20, and EX-HN3.
- Poor quality of some included RCTs.
- Some studies lacked safety records.