Does acupuncture work in chronic spontaneous urticaria?

Acupuncture appears more effective than sham acupuncture or waitlist control in patients with chronic spontaneous urticaria (CSU), but the difference from control does not reach statistical significance, reports a study. Adverse events (AEs) associated with acupuncture are either mild or transient.

A total of 330 patients with CSU were included in this multicentre, randomized, sham-controlled trial conducted across three teaching hospitals in China from 27 May 2019 to 30 July 2022. Participants were randomly assigned to receive acupuncture, sham acupuncture, or waitlist control over 8 weeks (4 weeks for treatment and 4 weeks for follow-up).

The mean change in the Weekly Urticaria Activity Score (UAS7) for acupuncture from baseline (mean score, 23.5, 95 percent confidence interval [CI], 21.8‒25.2) to week 4 (mean score, 15.3, 95 percent CI, 13.6‒16.9) was ‒8.2 (95 percent CI, ‒9.9 to‒6.6).

For sham acupuncture and waitlist control, the mean changes in UAS7 from baseline (corresponding mean scores, 21.9 and 22.1) to week 4 (corresponding mean scores, 17.8 and 20.0) were ‒4.1 (95 percent CI, ‒5.8 to ‒2.4) and ‒2.2 (95 percent CI, ‒3.8 to ‒0.5), respectively.

The mean differences between acupuncture and sham acupuncture and waitlist control were ‒4.1 (95 percent CI, ‒65. To ‒1.8) and ‒6.1 (95 percent CI, ‒8.4 to ‒3.7), respectively. These values did not meet the threshold for the minimal clinically important difference.

Additionally, AEs occurred in 15 participants (13.6 percent) in the acupuncture group and none in the other groups. Most of these AEs were mild or transient.

This study was limited by the lack of complete blinding, self-reported outcomes, limited generalizability because antihistamine use was disallowed, and short follow-up period.