Sham and Real Electroacupuncture Reduce Hot Flashes vs Gabapentin and Pill Placebo in Breast Cancer Survivors
- Sham acupuncture reduced hot flashes more than pill placebo and was associated with fewer adverse events in breast cancer survivors.
- Electroacupuncture produced the greatest reduction in hot flashes.
In a study assessing placebo effects reported in the Journal of Clinical Oncology, Mao et al found that sham electroacupuncture produced a greater reduction in hot flashes than placebo pills and gabapentin, with the greatest reduction being achieved with real electroacupuncture.
In the study, 120 women with bothersome hot flashes at least twice per day were randomly assigned to receive electroacupuncture twice per week for 2 weeks and then once per week for 6 weeks (n = 30), sham electroacupuncture (n = 32), gabapentin at 900 mg once daily (n = 28), or a placebo pill for 8 weeks (n = 30). The primary endpoint was change in the hot flash composite score (HFCS) between sham acupuncture and pill placebo at week 8; secondary endpoints included group comparisons and evaluation at week 24 for durability of effects.
Hot Flash Reductions
At week 8, sham acupuncture was associated with a significantly greater reduction in hot flash composite score vs pill placebo (difference = −2.39, 95% confidence interval = −4.60 to −0.17). Among all treatment groups, mean reductions in hot flash composite score at 8 weeks were 7.4, 5.9, 5.2, and 3.4 (P < .001) in the electroacupuncture, sham acupuncture, gabapentin, and pill placebo groups. At week 24, mean reductions were 8.5, 6.1, 4.6, and 2.8 (P = .002). Treatment-related adverse events occurred in 39.3% of the gabapentin group, 20.0% of the pill placebo group, 16.7% of the electroacupuncture group, and 3.1% of the sham acupuncture group (P = .005).
The investigators concluded: “Acupuncture produced larger placebo and smaller nocebo effects than did pills for the treatment of hot flashes. [Electroacupuncture] may be more effective than [gabapentin], with fewer adverse effects for managing hot flashes among breast cancer survivors; however, these preliminary findings need to be confirmed in larger randomized controlled trials with long-term follow-up.”
Jun J. Mao, MD, MSCE, of University of Pennsylvania, is the corresponding author for the Journal of Clinical Oncology article.
The study was supported by the National Center for Complementary and Integrative Health. For full disclosures of the study authors, visit jco.ascopubs.org.