PMID- 34489268
OWN - NLM
STAT- MEDLINE
DCOM- 20210915
LR  - 20210923
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 11
IP  - 9
DP  - 2021 Sep 6
TI  - Acupuncture-related adverse events: systematic review and meta-analyses of 
      prospective clinical studies.
PG  - e045961
LID - 10.1136/bmjopen-2020-045961 [doi]
LID - e045961
AB  - OBJECTIVE: Overview on risks of acupuncture-related adverse events (AEs). DESIGN: 
      Systematic review and meta-analyses of prospective studies. DATA SOURCES: PubMed, 
      Scopus and Embase from inception date to 15 September 2019. ELIGIBILITY CRITERIA 
      FOR SELECTING STUDIES: Prospective studies assessing AEs caused by needle 
      acupuncture in humans as primary outcome published in English or German. DATA 
      EXTRACTION AND SYNTHESIS: Two independent researchers selected articles, 
      extracted the data and assessed study quality. Overall risks and risks for 
      different AE categories were obtained from random effects meta-analyses. MAIN 
      OUTCOMES: Overall risk of minor AEs and serious adverse events (SAEs) per 
      patients and per treatments. RESULTS: A total of 7679 publications were 
      identified. Twenty-two articles reporting on 21 studies were included. 
      Meta-analyses suggest at least one AE occurring in 9.31% (95% CI 5.10% to 14.62%, 
      11 studies) of patients undergoing an acupuncture series and in 7.57% (95% CI 
      1.43% to 17.95%, 5 studies) of treatments. Summary risk estimates for SAEs were 
      1.01 (95% CI 0.23 to 2.33, 11 studies) per 10 000 patients and 7.98 (95% CI 1.39 
      to 20.00, 14 studies) per one million treatments, for AEs requiring treatment 
      1.14 (95% CI 0.00 to 7.37, 8 studies) per 1000 patients. Heterogeneity was 
      substantial (I(2) >80%). On average, 9.4 AEs occurred in 100 treatments. Half of 
      the AEs were bleeding, pain or flare at the needle site that are argued to 
      represent intended acupuncture reaction. AE definitions and assessments varied 
      largely. CONCLUSION: Acupuncture can be considered among the safer treatments in 
      medicine. SAEs are rare, and the most common minor AEs are very mild. AEs 
      requiring medical management are uncommon but necessitate medical competence to 
      assure patient safety. Clinical and methodological heterogeneity call for 
      standardised AE assessments tools, clear criteria for differentiating 
      acupuncture-related AEs from therapeutically desired reactions, and 
      identification of patient-related risk factors for AEs. PROSPERO REGISTRATION 
      NUMBER: CRD42020151930.
CI  - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Baumler, Petra
AU  - Baumler P
AUID- ORCID: 0000-0002-3262-2993
AD  - Multidisciplinary Pain Centre, Department of Anaesthesiology, University Hospital 
      LMU Munich, Munich, Germany Petra.Baeumler@med.uni-muenchen.de.
FAU - Zhang, Wenyue
AU  - Zhang W
AD  - School of Acupuncture, Moxibustion and Tuina, Beijing Rehabilitation Hospital, 
      Beijing University of Chinese Medicine, Beijing, China.
FAU - Stubinger, Theresa
AU  - Stubinger T
AD  - Multidisciplinary Pain Centre, Department of Anaesthesiology, University Hospital 
      LMU Munich, Munich, Germany.
FAU - Irnich, Dominik
AU  - Irnich D
AD  - Multidisciplinary Pain Centre, Department of Anaesthesiology, University Hospital 
      LMU Munich, Munich, Germany.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210906
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - *Acupuncture Therapy/adverse effects
MH  - Humans
MH  - Prospective Studies
PMC - PMC8422480
OTO - NOTNLM
OT  - adverse events
OT  - complementary medicine
OT  - general medicine (see internal medicine)
OT  - pain management
OT  - quality in healthcare
OT  - risk management
COIS- Competing interests: DI reports receiving honorarium and travel costs from 
      non-profit academic organisations, physician chambers and universities for 
      teaching and lecturing, and serving as president of the German Medical 
      Acupuncture Association (Deutsche Arztegesellschaft fur Akupunktur, DAGfA, a 
      non-profit medical association). PB declares receiving honorarium and travel 
      costs from non-profit academic organisations and universities for teaching and 
      lecturing and being a member of the scientific advisory board of the DAGfA. WZ 
      and TS declare no other relationships or activities that could appear to have 
      influenced the submitted work.
EDAT- 2021/09/08 06:00
MHDA- 2021/09/16 06:00
PMCR- 2021/09/06
CRDT- 2021/09/07 07:00
PHST- 2021/09/07 07:00 [entrez]
PHST- 2021/09/08 06:00 [pubmed]
PHST- 2021/09/16 06:00 [medline]
PHST- 2021/09/06 00:00 [pmc-release]
AID - bmjopen-2020-045961 [pii]
AID - 10.1136/bmjopen-2020-045961 [doi]
PST - epublish
SO  - BMJ Open. 2021 Sep 6;11(9):e045961. doi: 10.1136/bmjopen-2020-045961.