Migraine: RCT further supports preventive benefit of acupuncture

  • BMJ

  • curated by Susan London
  • Clinical Essentials
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Takeaway

  • Compared with sham acupuncture, true manual acupuncture in this randomized controlled trial (RCT) reduced migraine days and attacks in patients having episodic migraine without aura not receiving pharmacologic prophylaxis.

Why this matters

  • Editorial: “We now have good evidence that acupuncture is an effective treatment for episodic migraine." 

Key results

  • Reduction in mean number of migraine days, true manual vs sham acupuncture:
    • –3.5 vs –2.4 (adjusted difference, −1.4; P=.005) at weeks 13-16 and
    • –3.9 vs –2.2 (adjusted difference, −2.1; P<.001 at weeks>
  • Reduction in mean number of migraine attacks, true manual vs sham acupuncture at weeks 17-20: –2.3 vs –1.6 (adjusted difference, −1.0; P<.001>
  • No severe adverse events.
  • Patients perceiving similar needle penetration in manual vs sham acupuncture: 79.3% vs 75.0% (P=.891).

Study design

  • Multicenter RCT in China; patients, outcome assessment, and statistician all blinded to treatment.
  • 150 patients having episodic migraine without aura were randomly allocated 2:2:1 to 8 weeks of following:
    • 20 sessions manual acupuncture at true acupuncture points plus usual care;
    • 20 sessions nonpenetrating sham acupuncture at heterosegmental nonacupuncture points plus usual care; and
    • Usual care (lifestyle changes, migraine self-management).
  • Main outcome: change in migraine days, attacks per 4 weeks during weeks 1-20 postrandomization vs baseline (4 weeks prerandomization).
  • Funding: National Natural Science Foundation of China; others.

Limitations

  • Patients not receiving prophylaxis at baseline.
  • Long-term benefit not assessable.
  • Unknown generalizability.