Electroacupuncture may improve opioid-induced constipation in patients with cancer
Click Here to Manage Email Alerts
Electroacupuncture increased weekly spontaneous bowel movements and improved quality of life in patients with cancer and opioid-induced constipation, according to data published in JAMA Network Open.
“Opioid-induced constipation (OIC) affects 60% to 90% of patients with cancer-related opioid use,” Weiming Wang, MD, PhD, of the department of acupuncture and moxibustion at Guang’anmen Hospital in Beijing, and colleagues wrote. “Opioid-induced constipation can have a profound negative effect on the activities of daily living and overall quality of life of patients with moderate to severe cancer pain.
“A recent meta-analysis suggested that acupuncture might relieve constipation and improve quality of life for patients with OIC; however, the evidence was very low quality because the included studies had inherent flaws.”
In a multicenter, randomized clinical trial, Wang and colleagued evaluated the safety and efficacy of electroacupuncture (EA) for OIC in 100 patients (mean age, 64.4 years; 56% men) with cancer. From May 2019 to December 2021, patients received 24 sessions of EA (n = 50) or sham electroacupuncture (n = 50) over 8 weeks and were monitored for up to 8 weeks after treatment.
The primary outcome was the proportion of overall responders, which researchers defined as participants who had at least three spontaneous bowel movements (SBMs) per week with an increase of at least one SBM from baseline per week for at least 6 to 8 weeks of the treatment period.
Wang and colleagues reported that 88% of patients in the EA group and 84% of patients in the sham group received at least 20 sessions of acupuncture treatment.
According to results, there was a “significantly higher” proportion of overall responders in the EA group (40.1%; 95% CI, 26.1-54.1) compared with the sham group (9%; 95% CI, 0.5-17.4). Further, researchers reported a “significant increase” in the number of mean weekly SBMs in the EA group from baseline over weeks 1 to 8 (1.2 SBMs; 95% CI, 1-1.3 vs. 0.6 SMBs; 95% CI, 0.4-0.8 [between-group difference = 0.6 SBMs; 95% CI, 0.3-0.8]) and weeks 13 to 16 (0.6; 95% CI, 0.5-0.8 vs. 0.2; 95% CI, 0.04-0.4 [0.4 SBMs; 95% CI, 0.1-0.6]).
Researchers also reported that while EA had no effect on cancer pain or opioid dosage, it decreased defecation straining and improved quality of life in patients. Acupuncture-related adverse events were mild and transient, with rare serious adverse events reported.
“In this randomized clinical trial, an 8-week EA treatment exhibited a consistent and stable benefit with a good safety profile for OIC in adult patients with cancer. The effects of EA did not interfere with opioid analgesia,” Wang and colleagues concluded. “Electroacupuncture may be considered as an alternative for the management of OIC in patients with chronic cancer pain.”
Collapse
Read more about
Click Here to Manage Email Alerts