Acupuncture may offer limited relief to patients with chronic hives

A randomized controlled trial that included more than 300 people diagnosed with chronic spontaneous urticaria (CSU)—hives—has found that acupuncture may offer limited relief from the condition, but clinical significance of this finding was unclear. The study is published in Annals of Internal Medicine.

CSU is the most common form of chronic hives and is characterized by recurrent itching, skin lesions, or swelling lasting more than six weeks in the absence of specific triggering factors. More than 90% of patients with CSU require urgent medical treatment to relieve itching; therefore, the management of itching is one of the main goals in the treatment of CSU.

Researchers from Chengdu University of Traditional Chinese Medicine randomly assigned 330 persons diagnosed with CSU to receive either four weeks of acupuncture, four weeks of sham acupuncture, or a waitlist (control), and then followed the patients for four weeks after treatment to investigate whether acupuncture leads to improvement of CSU symptoms. Changes in symptoms were measured using the Weekly Urticaria Activity Score (UAS7).

Patients in the acupuncture group reported improved UAS7, more than sham acupuncture or waitlist control. However, the differences between intervention and control did not meet the minimal clinical difference (MCID) threshold, so the clinical significance of the observed reductions in itch severity scores is uncertain. The rate of adverse events was highest in the acupuncture group, but events were mild and transient.

An accompanying editorial by Mike Cummings of the British Medical Acupuncture Society highlights that these trial results are interesting because they describe the efficacy of acupuncture in a condition that is not characterized by pain. While clinical significance of the findings was not clear, the author suggests that clinicians should stay open to the potential for adjunctive use of acupuncture to influence outcomes, even in more serious medical conditions.

The editorial suggests that acupuncture is often overlooked as a therapy because it lacks the commercial backing of other modern interventions.