According to a study, a randomized phase III trial presented at the 2017 San Antonio Breast Cancer Symposium (SABCS). A mix of traditional and customized acupuncture techniques proved effective in reducing pain and stiffness associated with aromatase inhibitor (AI) therapy in women with early-stage breast cancer.

Investigators said a 12-week intervention program demonstrated the value of the therapy to help relieve symptoms that may cause patients to skip or stop treatments. “We have heard throughout this conference about the efficacy of AIs for women with hormone-sensitive breast cancer. It works both in the adjuvant setting in women with metastatic disease, and for the prevention of breast cancer.” said Dawn L. Hershman.

Hershman approved that noncompliance can be multifactorial, but one of the main reasons patients discontinue treatment is because of adverse effects and joint pain and stiffness. Improved joint pain score after 6 weeks served as the primary endpoint. The researchers also evaluated maintenance acupuncture efficacy from weeks 6 through 12, followed by an additional 12-week follow-up.

True acupuncture and sham treatments included twice-weekly sessions for 6 weeks followed by 1 session per week for 6 more weeks. Patients were a median 60.7 years of age, and had been receiving AI therapy for a median of 1.1 years. Forty-four women previously received acupuncture therapy for other conditions (19%).

At baseline, women reported BPI worst pain scores of 6.84, 6.55, and 6.48 in the true, sham, and waitlist arms, respectively. After 6 weeks of treatment, mean BPI worst pain scores were 0.92 points lower in the true acupuncture arm (95% CI, 0.20-1.65; = .01) compared with the sham arm, and 0.96 points lower than the waitlist control arm (95% CI, 0.24-1.67; P = .01).

Additionally, the true acupuncture arm demonstrated a greater proportion of patients reporting clinically meaningful reductions in BPI worst pain of 2 points or more (58%), compared with the sham (31%; P < .009) and waitlist arms (30%; P < .004). According to a linear mixed model, these data remained statistically significant at 24 weeks.

The true acupuncture arm also outperformed the sham and waitlist arms in additional 6-week endpoints, including more favorable BPI scores for average pain, pain interference, pain severity, and worse stiffness. Similarly, these results were maintained after 24 weeks according to a linear mixed model.

Grade 1 bruising appeared to be the only significant adverse event reported among true (47%) and sham acupuncture patients (25%; P = .01). “Acupuncture provides a nonpharmacologic option that can improve symptoms and possibly increase AI adherence as well as subsequent breast cancer outcomes,” Hershman said.

Authors feel there is now sufficient evidence to support insurance coverage of acupuncture for AI arthralgia.