MSBlog: Acupuncture for fatigue. Science of fiction?
BACKGROUND: Fatigue is a common symptom in MSers. It has significant negative effects on the quality of life. There are few therapeutic modalities for fatigue, which are also usually not sufficiently effective. The aim of this study was to evaluate the efficacy of acupuncture on this common symptom.
METHODS: In this before-and-after clinical trial, 40 patients with a definite diagnoses of MS, according to the 'McDonald' criteria, were studied. MSers who had Expanded Disability Status Scale (EDSS) scores greater than 4, or who had another disease that could be potentially responsible for their fatigue, were excluded from the study. In all, 20 MSers with fatigue refractory to amantadine underwent 12 sessions of acupuncture. Fatigue was scored according to the Fatigue Severity Scale (FSS).
RESULTS: A total of 15 (37.5%) MSers with fatigue responded to amantadine. The mean FSS score reduction after 2 months of treatment was 8±4, which was statistically significant (p<0.001). Of the 20 MSers who were resistant to amantadine, 5 (25%) responded to acupuncture combined with amantadine treatment. The FSS scores of the 20 MSers who were refractory were significantly reduced after this treatment (mean: 13±6, p<0.001).
CONCLUSIONS: Acupuncture appears to be associated with benefits for a proportion of MSers with fatigue who are resistant to conventional drugs such as amantadine.
"Use of acupuncture for fatigue is new to me. I am having difficulty with a mechanism of action. Have any of you had acupuncture and had a response? My personal experience with using amantadine is similar to this study."
"Overall this trial is very poorly designe; it is open-labelled and non-randomised. Therefore it cannot be used as part of any evidence-based decision making. Why do we do, and allow, poor science? It is unethical in 2012! All these results could be explained by the placebo effect. "
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