Acupuncture for Patients With Migraine

[Guest guest]

FYI…

A. Simpson, DC, DABCO

Vice President, Medical Director

Complementary Healthcare Plans, Inc

6600 SW 105th Avenue,

Suite 115

Beaverton,

OR 97008

503-619-2041

Acupuncture

for Patients With Migraine

A Randomized Controlled Trial

Klaus Linde, MD; Streng, PhD; ne Jürgens, MSc;

Hoppe, MD; Benno Brinkhaus, MD; Witt, MD; Stephan Wagenpfeil, PhD; Volker

Pfaffenrath, MD; G. Hammes, MD; Wolfgang Weidenhammer, PhD; Stefan N.

Willich, MD, MPH; Dieter Melchart, MD

JAMA. 2005;293:2118-2125.

Context Acupuncture is widely used to prevent migraine attacks,

but the available evidence of its benefit is scarce.

Objective To investigate the effectiveness of acupuncture compared

with sham acupuncture and with no acupuncture in patients with

migraine.

Design, Setting, and Patients Three-group, randomized, controlled trial (April

2002-January 2003) involving 302 patients (88% women), mean (SD) age

of 43 (11) years, with migraine headaches, based on International

Headache Society criteria. Patients were treated at 18 outpatient

centers in Germany.

Interventions Acupuncture, sham acupuncture, or waiting list

control. Acupuncture and sham acupuncture were administered by

specialized physicians and consisted of 12 sessions per patient over

8 weeks. Patients completed headache diaries from 4 weeks before to

12 weeks after randomization and from week 21 to 24 after

randomization.

Main Outcome Measures Difference in headache days of moderate or severe

intensity between the 4 weeks before and weeks 9 to 12 after

randomization.

Results Between baseline and weeks 9 to 12, the mean (SD) number

of days with headache of moderate or severe intensity decreased by

2.2 (2.7) days from a baseline of 5.2 (2.5) days in the acupuncture

group compared with a decrease to 2.2 (2.7) days from a baseline of

5.0 (2.4) days in the sham acupuncture group, and by 0.8 (2.0) days

from a baseline if 5.4 (3.0) days in the waiting list group. No

difference was detected between the acupuncture and the sham

acupuncture groups (0.0 days, 95% confidence interval, –0.7 to

0.7 days; P = .96)

while there was a difference between the acupuncture group compared with

the waiting list group (1.4 days; 95% confidence interval; 0.8-2.1

days; P<.001). The proportion

of responders (reduction in headache days by at least 50%) was 51%

in the acupuncture group, 53% in the sham acupuncture group, and 15%

in the waiting list group.

Conclusion Acupuncture was no more effective than sham acupuncture

in reducing migraine headaches although both interventions were more

effective than a waiting list control.

Author Affiliations: Centre for Complementary Medicine Research, Department of

Internal Medicine II (Drs Linde, Streng, Hoppe, Weidenhammer, and Melchart and

Mrs Jürgens), Institute of Medical Statistics and Epidemiology (Dr Wagenpfeil),

and Department of Neurology (Dr Hammes), Technische Universität München,

Munich, Germany; Institute of Social Medicine, Epidemiology, and Health

Economics, Charité University Medical Center, Berlin, Germany (Drs Brinkhaus,

Witt, and Willich); Munich, Germany (Dr Pfaffenrath); and Division of Complementary

Medicine, Department of Internal Medicine, University Hospital Zurich, Zurich,

Switzerland (Dr Melchart).