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Complement Ther Med. 2018 Apr;37:143-157. doi: 10.1016/j.ctim.2018.03.003. Epub 2018 Mar 5.

Complementary and alternative medicine for rheumatic diseases: A systematic review of randomized controlled trials.

Author information

1
Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.
2
Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore. Electronic address: yuheng@u.duke.nus.edu.
3
Faculty of Science, National University of Singapore, Singapore.
4
Faculty of Medicine, University of Queensland, Australia.
5
Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore.
6
Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Abstract

OBJECTIVES:

To summarize all good quality randomized controlled trials (RCTs) using complementary and alternative medicine (CAM) interventions in patients with rheumatic diseases.

METHODS:

A systematic literature review guided by the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) was performed. We excluded non-English language articles and abstract-only publications. Due to the large number of RCTs identified, we only include "good quality" RCTs with Jadad score of five.

RESULTS:

We identified 60 good quality RCTs using CAM as intervention for patients with rheumatic diseases: acupuncture (9), Ayurvedic treatment (3), homeopathic treatment (3), electricity (2), natural products (31), megavitamin therapies (8), chiropractic or osteopathic manipulation (3), and energy healing therapy (1). The studies do not seem to suggest a particular type of CAM is effective for all types for rheumatic diseases. However, some CAM interventions appear to be more effective for certain types of rheumatic diseases. Acupuncture appears to be beneficial for osteoarthritis but not rheumatoid arthritis. For the other therapeutic modalities, the evidence base either contains too few trials or contains trials with contradictory findings which preclude any definitive summary. There were only minor adverse reactions observed for CAM interventions presented.

CONCLUSION:

We identified 60 good quality RCTs which were heterogenous in terms of interventions, disease, measures used to assess outcomes, and efficacy of CAM interventions. Evidence indicates that some CAM therapies may be useful for rheumatic diseases, such as acupuncture for osteoarthritis. Further research with larger sample size is required for more conclusive evidence regarding efficacy of CAM interventions.

KEYWORDS:

Complementary and alternative medicine; Rheumatic diseases; Systematic review

PMID:
29609927
DOI:
10.1016/j.ctim.2018.03.003
[Indexed for MEDLINE]

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