IBS-D: acupuncture tops medical therapy in meta-analysis

  • Zhu L & al.
  • Evid Based Complement Alternat Med
  • 1 Jan 2018

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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:
    • rifaximin;
    • alosetron;
    • ramosetron and pinaverium bromide;
    • sham acupuncture; and
    • acupuncture.
  • The most common acupuncture points were ST25, ST36, ST37, SP6, GV20, and EX-HN3.

Limitations

  • Poor quality of some included RCTs.
  • Some studies lacked safety records.

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