Electroacupuncture on par with prucalopride for severe chronic constipation relief

Electroacupuncture seems as effective and safe as prucalopride in relieving severe chronic constipation (SCC), a recent study has shown. Moreover, the effects of 8-week electroacupuncture persist for 24 weeks after treatment.

In this multicentre, randomized, noninferiority trial, the investigators randomly allocated 560 participants with SCC (≤2 mean weekly complete spontaneous bowel movements [CSDMs]) to receive either 28-session electroacupuncture over 8 weeks with follow-up without treatment over 24 weeks (n=280) or prucalopride (2 mg/d before breakfast; n=280) over 32 weeks.

The proportion of participants with ≥3 mean weekly CSBMs over weeks 3–8, based on the modified intention-to-treat population, with −10 percent as the noninferior margin, was the main outcome.

Electroacupunture demonstrated noninferiority to prucalopride for the primary outcome (36.2 percent vs 37.8 percent; difference, –1.6 percent, 95 percent confidence interval [CI], –8 percent to 4.7 percent; p<0.001 for noninferiority). Almost the same results were seen in the per-protocol population.

The proportions of overall CSBM responders through weeks 1–8 were comparable between the electroacupuncture and prucalopride groups (24.91 percent vs 25.54 percent; difference, –0.63 percent, 95 percent CI, –7.86 percent to 6.60 percent; p=0.864). No between-group differences were noted in excessive straining, stool consistency, and quality of life, except during the first 2-week treatment.

Adverse events occurred less frequently in the electroacupuncture group than in the prucalopride group (49 [17.69 percent] vs 123 [44.24 percent]). One serious adverse event was recorded in the former, but it was not related to the treatment.

“Electroacupuncture is a promising noninferior alternative for SCC,” the investigators said.