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NEW YORK, Nov. 13 (UPI) -- Acupuncture may offer limited relief to patients with chronic hives, a new Chinese study indicates. Results of the randomized controlled trial that included more than 300 people diagnosed with chronic spontaneous urticaria, were published Monday in Annals of Internal Medicine.
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Chronic spontaneous urticaria -- the most common form of chronic hives -- is marked by recurrent itching, skin lesions or swelling lasting more than six weeks in the absence of specific triggering factors.
More than 90% of patients with the condition need urgent medical treatment to relieve itching. As a result, the management of itching is one of the main goals of treatment.
"Chronic spontaneous urticaria is a prevalent dermatological condition affecting approximately 1% of the global population," the study's lead author, Dr. Ying Li, a professor at Chengdu University of Traditional Chinese Medicine in Chengdu, Sichuan, China, told UPI via email.
Persistent itching and development of hives significantly impair patients' quality of life. While doctors typically recommend antihistamines to relieve symptoms, Li said a large percentage of patients do not find them helpful even when the dose is increased two- to four-fold.
A second-line treatment for these patients comes in the form of the costly injectable prescription medicine, Xolair (omalizumab). However, the drug "is not reimbursed in many countries, limiting its use to most patients worldwide," Li said.
"Given the shortcomings of existing therapies" for the itching associated with chronic hives, "novel therapeutic interventions or strategies are emerging," she said.
She added that "acupuncture, a traditional physical therapy with a rich historical background spanning over a millennium, has been regarded as an effective treatment for urticaria in China."
An editorial accompanying the study states that the trial results are interesting because they delve into the effectiveness of acupuncture for a condition that is not characterized by pain.
Although the clinical significance of the findings was not clear, clinicians should remain open to the potential for adjunctive use of acupuncture to influence outcomes, even in more serious medical conditions, according to a news release.
Acupuncture is often overlooked as a therapy because it lacks the commercial backing of other modern interventions, the editorial notes.
The editorial's author, Dr. Mike Cummings, medical director of the British Medical Acupuncture Society in London, told UPI via email that this study "is important because it demonstrates the potential for acupuncture to influence an inflammatory condition over the whole body and not simply alter a patient's perception of a symptom."
Dr. Shyam Joshi, section chief of the Allergy and Immunology Clinic at Oregon Health & Science University in Portland, told UPI in a telephone interview that this study is not the first to examine the effects of acupuncture on chronic hives.
But it's the first trial of which he is aware to "investigate this question in a robust way, in terms of having a treatment group as well as a sham group." An effective sham procedure pretends to deliver the active intervention -- in this case, acupuncture -- as comparably as possible without having any therapeutic effect.
"This was a really well-conceived study compared to all the previous studies," Joshi said, noting that participants in the acupuncture group showed some improvement in itching, depression and anxiety compared to the sham group. They received acupuncture or the sham procedure 16 times over the course of four weeks.
"Some patients can't tolerate the typical interventions that we use right now," he said, "so learning more about alternative options is always helpful in helping our patients in the long run."
However, the findings need to be further investigated in additional studies before physicians change their practice. Also, with the study being limited to patients in China, the results may not be generalizable to the U.S. population.
Dr. Nancy Wasserbauer Kingston, a senior attending physician in allergy and immunology at University Hospitals of Cleveland, told UPI via email that "the study raises some good points regarding the use of complementary and alternative medicine in a chronic condition for which we rarely have a good explanation for its cause.
"This condition is incredibly frustrating for patients and their physicians."
She added that "our immune system wants to maintain a healthy balance," and "the notion that acupuncture may help restore the immune balance" is valid. "But at the end of the day, the proposal that acupuncture reduces [itching] via certain receptors in the nervous system remains the debate."
While this short study highlights acupuncture's potential to help alleviate an annoying symptom, "it is not resolving the ultimate issue as to why the immune mechanism is activated," Kingston said.
Even so, "for a highly motivated patient who has access and the means to pursue such therapy, they may find some itch relief from acupuncture."
