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Effects of Electroacupuncture for Opioid-Induced Constipation in Patients With Cancer in China: A Randomized Clinical Trial
IMPORTANCE: Opioid-induced constipation (OIC) is prevalent among patients treated with opioids for cancer pain. Safe and effective therapies for OIC in patients with cancer remain an unmet need. OBJECTIVE: To determine the efficacy of electroacupuncture (EA) for OIC in patients with cancer. DESIGN,...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Medical Association
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947731/ https://www.ncbi.nlm.nih.gov/pubmed/36811861 http://dx.doi.org/10.1001/jamanetworkopen.2023.0310 |
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author | Wang, Weiming Liu, Yan Yang, Xiaofang Sun, Jianhua Yue, Zenghui Lu, Dianrong Zhou, Kehua Sun, Yuanjie Hou, Aihua Zang, Zhiwei Jin, Xiaoqing Liu, Chao Wang, Yuhang Yu, Jinna Zhu, Lili Liu, Zhishun |
author_facet | Wang, Weiming Liu, Yan Yang, Xiaofang Sun, Jianhua Yue, Zenghui Lu, Dianrong Zhou, Kehua Sun, Yuanjie Hou, Aihua Zang, Zhiwei Jin, Xiaoqing Liu, Chao Wang, Yuhang Yu, Jinna Zhu, Lili Liu, Zhishun |
author_sort | Wang, Weiming |
collection | PubMed |
description | IMPORTANCE: Opioid-induced constipation (OIC) is prevalent among patients treated with opioids for cancer pain. Safe and effective therapies for OIC in patients with cancer remain an unmet need. OBJECTIVE: To determine the efficacy of electroacupuncture (EA) for OIC in patients with cancer. DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was conducted at 6 tertiary hospitals in China among 100 adult patients with cancer who were screened for OIC and enrolled between May 1, 2019, and December 11, 2021. INTERVENTIONS: Patients were randomized to receive 24 sessions of EA or sham electroacupuncture (SA) over 8 weeks and then were followed up for 8 weeks after treatment. MAIN OUTCOMES AND MEASURES: The primary outcome was the proportion of overall responders, defined as patients who had at least 3 spontaneous bowel movements (SBMs) per week and an increase of at least 1 SBM from baseline in the same week for at least 6 of the 8 weeks of the treatment period. All statistical analyses were based on the intention-to-treat principle. RESULTS: A total of 100 patients (mean [SD] age, 64.4 [10.5] years; 56 men [56.0%]) underwent randomization; 50 were randomly assigned to each group. Among them, 44 of 50 patients (88.0%) in the EA group and 42 of 50 patients (84.0%) in the SA group received at least 20 (≥83.3%) sessions of treatment. The proportion of overall responders at week 8 was 40.1% (95% CI, 26.1%-54.1%) in the EA group and 9.0% (95% CI, 0.5%-17.4%) in the SA group (difference between groups, 31.1 percentage points [95% CI, 14.8-47.6 percentage points]; P < .001). Compared with SA, EA provided greater relief for most OIC symptoms and improved quality of life among patients with OIC. Electroacupuncture had no effects on cancer pain and its opioid treatment dosage. Electroacupuncture-related adverse events were rare, and, if any, all were mild and transient. CONCLUSIONS AND RELEVANCE: This randomized clinical trial found that 8-week EA treatment could increase weekly SBMs with a good safety profile and improve quality of life for the treatment of OIC. Electroacupuncture thus provided an alternative option for OIC in adult patients with cancer. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03797586 |
format | Online Article Text |
id | pubmed-9947731 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | American Medical Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-99477312023-02-24 Effects of Electroacupuncture for Opioid-Induced Constipation in Patients With Cancer in China: A Randomized Clinical Trial Wang, Weiming Liu, Yan Yang, Xiaofang Sun, Jianhua Yue, Zenghui Lu, Dianrong Zhou, Kehua Sun, Yuanjie Hou, Aihua Zang, Zhiwei Jin, Xiaoqing Liu, Chao Wang, Yuhang Yu, Jinna Zhu, Lili Liu, Zhishun JAMA Netw Open Original Investigation IMPORTANCE: Opioid-induced constipation (OIC) is prevalent among patients treated with opioids for cancer pain. Safe and effective therapies for OIC in patients with cancer remain an unmet need. OBJECTIVE: To determine the efficacy of electroacupuncture (EA) for OIC in patients with cancer. DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was conducted at 6 tertiary hospitals in China among 100 adult patients with cancer who were screened for OIC and enrolled between May 1, 2019, and December 11, 2021. INTERVENTIONS: Patients were randomized to receive 24 sessions of EA or sham electroacupuncture (SA) over 8 weeks and then were followed up for 8 weeks after treatment. MAIN OUTCOMES AND MEASURES: The primary outcome was the proportion of overall responders, defined as patients who had at least 3 spontaneous bowel movements (SBMs) per week and an increase of at least 1 SBM from baseline in the same week for at least 6 of the 8 weeks of the treatment period. All statistical analyses were based on the intention-to-treat principle. RESULTS: A total of 100 patients (mean [SD] age, 64.4 [10.5] years; 56 men [56.0%]) underwent randomization; 50 were randomly assigned to each group. Among them, 44 of 50 patients (88.0%) in the EA group and 42 of 50 patients (84.0%) in the SA group received at least 20 (≥83.3%) sessions of treatment. The proportion of overall responders at week 8 was 40.1% (95% CI, 26.1%-54.1%) in the EA group and 9.0% (95% CI, 0.5%-17.4%) in the SA group (difference between groups, 31.1 percentage points [95% CI, 14.8-47.6 percentage points]; P < .001). Compared with SA, EA provided greater relief for most OIC symptoms and improved quality of life among patients with OIC. Electroacupuncture had no effects on cancer pain and its opioid treatment dosage. Electroacupuncture-related adverse events were rare, and, if any, all were mild and transient. CONCLUSIONS AND RELEVANCE: This randomized clinical trial found that 8-week EA treatment could increase weekly SBMs with a good safety profile and improve quality of life for the treatment of OIC. Electroacupuncture thus provided an alternative option for OIC in adult patients with cancer. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03797586 American Medical Association 2023-02-22 /pmc/articles/PMC9947731/ /pubmed/36811861 http://dx.doi.org/10.1001/jamanetworkopen.2023.0310 Text en Copyright 2023 Wang W et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License. |
spellingShingle | Original Investigation Wang, Weiming Liu, Yan Yang, Xiaofang Sun, Jianhua Yue, Zenghui Lu, Dianrong Zhou, Kehua Sun, Yuanjie Hou, Aihua Zang, Zhiwei Jin, Xiaoqing Liu, Chao Wang, Yuhang Yu, Jinna Zhu, Lili Liu, Zhishun Effects of Electroacupuncture for Opioid-Induced Constipation in Patients With Cancer in China: A Randomized Clinical Trial |
title | Effects of Electroacupuncture for Opioid-Induced Constipation in Patients With Cancer in China: A Randomized Clinical Trial |
title_full | Effects of Electroacupuncture for Opioid-Induced Constipation in Patients With Cancer in China: A Randomized Clinical Trial |
title_fullStr | Effects of Electroacupuncture for Opioid-Induced Constipation in Patients With Cancer in China: A Randomized Clinical Trial |
title_full_unstemmed | Effects of Electroacupuncture for Opioid-Induced Constipation in Patients With Cancer in China: A Randomized Clinical Trial |
title_short | Effects of Electroacupuncture for Opioid-Induced Constipation in Patients With Cancer in China: A Randomized Clinical Trial |
title_sort | effects of electroacupuncture for opioid-induced constipation in patients with cancer in china: a randomized clinical trial |
topic | Original Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947731/ https://www.ncbi.nlm.nih.gov/pubmed/36811861 http://dx.doi.org/10.1001/jamanetworkopen.2023.0310 |
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