Acupuncture Reduces Itch in Adult Atopic Dermatitis

Gabriele Rotter, PhD, MSc

The use of acupuncture (ACU) was reported to reduce itching in patients with atopic dermatitis (AD), according to a new 3-armed randomized controlled single-center open explorative clinical trial.

A trend toward the reduction of topical corticosteroid (TCS) use in these patients due to ACU and osteopathic medicine (OM) was also recorded, though no differences in disease severity were observed.

In addition to TCS use, more than half of patients who struggle with AD use complementary medicine such as ACU and OM to manage their condition. Recent clinical studies have suggested that ACU was responsible for reducing itch and improving disease severity in AD, while limited evidence is available regarding the potential benefits of OM in adult AD.

As such, an investigative team led by Gabriele Rotter, PhD, MSc, of the Institute of Social Medicine, Epidemiology, and Health Economics in Berlin, considered the feasibility, efficacy, and cost-effectiveness of these treatments in adults with AD on a semi-standardized basis.

Computer-generated block randomization, stratified by TCS use within the last 4 weeks, enabled investigators to randomize adult patients with AD to receive ACU, OM, or no study intervention, with patients giving written and oral informed consent prior to enrollment.

Patients across the Berlin area were recruited via public transport advertisements, digital and print media. Patients were required to be anywhere from 18-65 years old with a diagnosis of AD and various AD symptoms, in addition to having a Three-Item Severity Score of 2 to 7 (TIS), and an average perceived itching intensity of the skin between 40 and 80 mm on a visual analog scale.

Those with other forms of dermatosis or systemic corticosteroid use within the previous 3 months were excluded.

Patients randomized to the ACU group received 8 semi-standardized treatments of 30 minutes at 1 to 2-week intervals, while those randomized to OM received five 45-minute semi-standardized OM treatments at roughly 2-week intervals.

Meanwhile, patients in the control group were presented with either 8 ACU treatments or 5 OM treatments after 12 weeks of no intervention, and were allowed to use routine care as it related to TCS and emollients.

No primary outcome was defined for this study, but general outcomes included disease severity measure by SCORing Atopic Dermatitis (SCORAD), itching intensity (VAS) and TCS use.

A total of 121 patients with a mean age of 31.4 years were included in the study, 92 of whom were female.

Though the adjusted mean SCORAD across all groups was similar, investigators found a clinically relevant difference in VAS itching between the ACU and control groups (95% CI 19.5, 36.4) (P=0.047), and the responder by VAS itching analysis indicated that ACU and OM was favored over the control group.

Additionally, TCS use was reduced in both treatment groups compared to controls (P=0.101). Beyond this, no other relevant differences between ACU or OM compared to the controls were observed.

“Future sufficiently powered RCTs with more intervention sessions should investigate the effectiveness of ACU and/or OM for itching, TCS use, and perceived skin condition, including in patients with severe AD,” Rotter and colleagues concluded.

The study, “Acupuncture and Osteopathic Medicine for Atopic Dermatitis- a Three-armed Randomized Controlled Explorative Clinical Trial,” was published online in Clinical and Experimental Dermatology.