title: Acupuncture for Aromatase Inhibitor-Induced Arthralgia: A Systematic Review.
abstract: BACKGROUND
  Aromatase inhibitors (AIs) are commonly used as adjunctive hormone treatment for early breast cancer patients. The major side effect of AIs is arthralgia, which affects adherence. Previous reviews suggested that acupuncture is effective in the management of cancer-related pain. The aim of this review is to evaluate the effects of acupuncture on arthralgia caused by AIs.
  
  
  METHODS
  This article examined randomized controlled trials (RCTs) measuring the effects of acupuncture on joint symptoms caused by AIs within 8 medical databases till May 2014. The quality of the articles was evaluated according to the Cochrane risk of bias (ROB) tool.
  
  
  RESULTS
  Four RCTs were identified in medical journals. Two studies were conducted with manual acupuncture and 2 studies were electroacupuncture. The range of sample size was between 32 and 67. One RCT showed significant improvement in the acupuncture group compared with the sham control group and another RCT showed a statistical difference between the electroacupuncture and waitlist group. The other 2 studies showed no statistical differences between control and acupuncture groups. Two studies conducted blood analysis to elucidate the mechanism of efficacy of acupuncture for arthralgia. The 2 positive studies had a lower ROB and 2 studies had a high ROB.
  
  
  CONCLUSIONS
  The systematic review suggests that acupuncture has potential benefits to improve arthralgia caused by AIs. However, further trials of adequate sample size, appropriate control group, and longer follow-up are necessary to investigate the efficacy of acupuncture in AI-induced arthralgia.
authors.affiliation: Royal North Shore Hospital, Sydney Medical School, Sydney, New South Wales, Australia East-West Cancer Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Korea kyeorebae@gmail.com.
authors.forename: Kyeore
authors.initials: K
authors.lastname: Bae
authors.affiliation: East-West Cancer Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Korea.
authors.forename: Hwa-Seung
authors.initials: HS
authors.lastname: Yoo
authors.affiliation: Royal North Shore Hospital, Sydney Medical School, Sydney, New South Wales, Australia Mater Hospital, Sydney Medical School, Sydney, New South Wales, Australia.
authors.forename: Gillian
authors.initials: G
authors.lastname: Lamoury
authors.affiliation: Mater Hospital, Sydney Medical School, Sydney, New South Wales, Australia.
authors.forename: Frances
authors.initials: F
authors.lastname: Boyle
authors.affiliation: Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Rosenthal
authors.affiliation: Royal North Shore Hospital, Sydney Medical School, Sydney, New South Wales, Australia Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: Byeongsang
authors.initials: B
authors.lastname: Oh
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D047072:Aromatase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D018771:Arthralgia / Q000139:chemically induced / Q000473:pathology / Q000628:therapy*; D001943:Breast Neoplasms / Q000188:drug therapy; D005260:Female; D006801:Humans; D016032:Randomized Controlled Trials as Topic
chemical_list: D047072:Aromatase Inhibitors
keywords: acupuncture; aromatase inhibitors; arthralgia; breast cancer; joint pain; pain management