Acupuncture beats gabapentin for hot flashes in RCT
SAN ANTONIO – Electroacupuncture
proved significantly more effective than gabapentin for treatment of hot
flashes in breast cancer survivors in a randomized, placebo-controlled clinical
trial.
Acupuncture was far better tolerated
as well. The rate of treatment-related adverse events was higher in patients
randomized to gabapentin than to women assigned to electroacupuncture, sham
acupuncture, or placebo, Dr. Jun J. Mao reported at the San Antonio Breast
Cancer Symposium.
The study included 120 women who had
completed their primary treatment for breast cancer and were experiencing
troublesome hot flashes at least twice daily. Participants were randomized to 8
weeks of treatment with electroacupuncture, sham acupuncture, gabapentin at 300
mg t.i.d., or placebo. The primary endpoint was change from baseline to week 8
in patients’ hot flash composite score as gleaned from their daily hot flash
diary. The secondary endpoint was durability of response based upon the hot
flash composite score at week 24, fully 4 months after patients went off
treatment, explained Dr. Mao, a family physician and licensed acupuncturist at
the University of Pennsylvania, Philadelphia.
From a baseline mean hot flash score
of 14.3, scores dropped by a mean of 7.4 points by week 8 in the
electroacupuncture recipients. This represented a significantly greater
treatment effect, compared with the reductions of 5.9 points with sham
acupuncture, 5.2 points with gabapentin, and 3.4 points with placebo.
Only acupuncture showed a durable
treatment benefit at 24 weeks. Indeed, the magnitude of the reduction in hot
flash scores 4 months after the final acupuncture session was, intriguingly,
even greater than at 8 weeks, both for electroacupuncture and sham acupuncture.
The mean reduction in hot flash score at 24 weeks was 8.5 points in the
electroacupuncture group, as compared with 7.4 points at week 8. Sham
acupuncture showed a mean 6.1-point decrease in the hot flash score at week 24,
gabapentin a 4.6-point reduction, and placebo a 2.8-point drop.
No serious adverse events were noted
during the study. However, 48% of gabapentin-treated patients reported
treatment-related adverse events, compared with 29% on placebo, 19% who got
electroacupuncture, and 3% with sham acupuncture, Dr. Mao continued.
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