AB1065 Preliminary findings of a 2-months acupuncture intervention on symptomatology and quality of life in patients with fibromyalgia
Authors: M. Di Carlo, G. Beci, F. Salaffi
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Acupuncture is frequently used in the treatment of different chronic pain conditions. In Fibromyalgia (FM) the evidences available are someway conflicting, and the correct positioning of such kind of therapy has not yet precisely defined. <h3>Objectives</h3> To assess the response to a single course of acupuncture in patients with FM non-responsive to the usual pharmacological treatment. <h3>Methods</h3> Consecutive FM patients with unsatisfactory response or intolerance to the pharmacologic treatment (duloxetine and/or pregabalin) were involved in this study. Unsatisfactory response was defined by the presence of a revised Fibromyalgia Impact Questionnaire (FIQ-R) total score ≥40 and of a Patient Health Questionnaire 15 (PHQ15) ≥5 after 3 months of stable pharmacological treatment. Acupuncture treatment consisted in 8 weekly sessions. The acupuncture formula, according to the Traditional Chinese Medicine indications, included the following points: LV3 +LI4 (to move Qi), ST36 +CV6+CV12 (to tonify Qi and Blood), GV20 (to raise Qi), and Ex-HN-3 (Yintang) (to calm the Shen), with acupuncture needle 0.25 × 25 mm with guide tube (Huanqiu). For each session needles were retained for 30 min. At baseline (before the first session) and at the end of the treatment course (after the eighth session) were collected the number of tender points (TP) and patient-reported outcomes (PROs). Differences between baseline and end of the acupuncture treatment were evaluated through the Wilcoxon test, results expressed in median values with 95% confidence interval (CI). <h3>Results</h3> Thirty-four subjects were enrolled in the study. Thirty-two patients (29 women, 3 men, mean age 49 years, range 18–72 years) completed the acupuncture treatment. In two patients (one woman and one man) the acupuncture therapy was stopped at the second session for poor tolerance to the needles. Eleven patients were in pharmacological therapy with pregabalin, nine with duloxetine, while 12 resulted intolerant both to pregabalin and duloxetine. From baseline, after the 2 months of acupuncture treatment, different parameters showed a significant improvement. Particularly, it has been observed a significant reduction in the TP number (17 [95% CI 16–18] à 10 [95% CI 8–12]; p&lt;0.0001), in the somatic symptoms assessed with the PHQ15 (13.5 [10.0–17.0] à 7.0 [6.0–10.0]; p&lt;0.0001), but also in the FIQ-R total score (61.5 [39.8–70.3] à [30.2–66.5]; p=0.0029), in the Fibromyalgia Activity Score (FAS) (6.7 [4.8–7.7] à 4.6 [CI 3.2–6.1]; p=0.0017), and in the Self-Assessment Pain Scale (SAPS) (4.5 [3.8–5.6] à 3.2 [2.9–4.2]; p=0.0192). Interestingly, acupuncture revealed a good effect even in the neuropatic-like features of pain, measured by the painDETECT questionnaire (19.0 [15.0–25.0] à 14.5 [10.9–17.0]). <h3>Conclusions</h3> A 2 months acupuncture treatment provides an important global improvement in the health status in FM patients refractory/intolerant to the pharmacologic therapy. The strongest ameliorations are represented by the reduction in the TP number and in the somatic symptoms. <h3>References</h3> [1] Häuser W, Clauw DJ, Fitzcharles MA. Treat-to-Target Strategy for Fibromyalgia: Opening the Dialogue. Arthritis Care Res2017; doi: 10.1002/acr.22970. [2] Langhorst J, Heldmann P, Henningsen P, et al. Complementary and alternative procedures for fibromyalgia syndrome: Updated guidelines 2017 and overview of systematic review articles. Schmerz2017; doi: 10.1007/s00482–017–0206–1. <h3>Disclosure of Interest</h3> None declared