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Feasibility Trial of Electroacupuncture for Aromatase Inhibitor—Related Arthralgia in Breast Cancer Survivors

Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania, jun.mao{at}uphs.upenn.edu, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania, Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Deborah W. Bruner, PhD, RN, FAAN

Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Carrie Stricker, PhD, RN, AOCN

Department of Medicine University of Pennsylvania Health System, Philadelphia, Pennsylvania, Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania

John T. Farrar, MD

Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Sharon X. Xie, PhD

Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Marjorie A. Bowman, MD, MPA

Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Donna Pucci, MHK

Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Xiaoyan Han, MS

Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Angela DeMichele, MD, MSCE

Department of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, Abramson Cancer Center, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Background. Arthralgia affects postmenopausal women receiving aromatase inhibitors (AIs) for breast cancer. Given the existing evidence for electroacupuncture (EA) for treatment of osteoarthritis in the general population, this study aims to establish the feasibility of studying EA for treating AI-related arthralgia. Patients and Methods. Postmenopausal women with stage I-III breast cancer who reported AI-related arthral gia were enrolled in a single-arm feasibility trial. EA was provided twice a week for 2 weeks followed by 6 weekly treatments. The protocol was based on Chinese medicine diagnosis of "Bi" syndrome with electrostimulation of needles around the painful joint(s). Pain severity of the modified Brief Pain Inventory was used as the primary outcome. Joint stiffness, joint interference, and Patient Global Impression of Change (PGIC) were secondary outcomes. Paired t tests were used for analysis. Results. Twelve women were enrolled and all provided data for analysis. From baseline to the end of intervention, patients reported reduction in pain severity (from 5.3 to 1.9), stiffness (from 6.9 to 2.4), and joint symptom interference (from 4.7 to 0.8), all P < .001; 11/12 considered joint symptoms "very much better" based on the PGIC. Subjects also reported significant decrease in fatigue (from 4.4 to 1.9, P = .005) and anxiety (from 7.1 to 4.8, P = .01). No infection or development or worsening of lymphedema was observed. Conclusion. Preliminary data establish the feasibility of recruitment and acceptance as well as promising preliminary safety and effectiveness. A randomized controlled trial is warranted to establish the efficacy of EA for AI-related arthralgia in breast cancer survivors.

Key Words: acupuncture • breast neoplasm • clinical trial • aromatase inhibitors • adverse effects • joint diseases

Integrative Cancer Therapies, Vol. 8, No. 2, 123-129 (2009)
DOI: 10.1177/1534735409332903


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