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Efficacy of acupuncture-related therapy in the treatment of knee osteoarthritis: a network meta-analysis of randomized controlled trials. Knee osteoarthritis (KOA) is a degenerative disease in which articular cartilage and synovial fluid in the knee are lost, leading to lower limb disability, particularly in elderly individuals.[1] While nonsteroidal anti-inflammatory drugs (NSAIDs) can improve the physical function of KOA patients, they pose a significant risk of gastrointestinal adverse events that hinder disease management.[2] Acupuncture (AT) is one of the most common non-pharmacological therapies for the treatment of musculoskeletal disease-related symptoms.[3] Although evidence supports the potential effectiveness of acupuncture in treating KOA-related symptoms, the findings are controversial.[4] Therefore, we conducted a systematic review, quantitative analysis, and summary of existing evidence to investigate the safety and effectiveness of acupuncture for KOA. Acupuncture Trialists C. The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain. [Extracted from the article]

Background: The acupoint selections impact the effects of acupuncture, and preliminary evidence showed potential connection between pain threshold (PT) and acupuncture response. This study examined whether acupuncture at acupoints with lower PT versus higher PT would yield different effects in patients with knee osteoarthritis (KOA). Methods: In this multicenter randomized clinical trial, patients were randomly assigned (1:1:1) to receive acupuncture at acupoints with lower PT (LPT group), acupuncture at acupoints with higher PT (HPT group), and no acupuncture (waiting-list group). PT was measured with electronic von Frey detector. The primary outcome was the change in WOMAC total score from baseline to 16 weeks, and the secondary outcomes were SF-12 score, and active knee range of motion (ROM). Intention-to-treat analysis was conducted with linear mixed-effect model. Results: Among 666 randomized patients, 625 (93.84%) completed the study. From baseline to 16 weeks, patients in the LPT group versus HPT group had similar effects in reducing WOMAC total score (adjusted mean difference (MD) 2.21, 95% confidence interval (CI) −2.51 to 6.92, P = 0.36), while a greater reduction in WOMAC total score was observed in LPT group (−9.77, 95% CI −14.47 to −5.07, P < 0.001) and HPT group (−11.97, 95% CI −16.71 to −7.24, P < 0.001) compared with waiting-list group. There were no differences in SF-12 score and knee ROM between LPT versus HPT groups. Conclusion: Our findings found that the effects of acupuncture at acupoints with lower versus higher PT were similar, both were effective for patients with KOA. Trial registration: ClinicalTrials.gov identifier: NCT03299439. Registered 3 October 2017, https://clinicaltrials.gov/ct2/show/NCT03299439 [ABSTRACT FROM AUTHOR]