Jamie Gisby

Acupuncture recommended for allergic rhinitis

The American Academy of Otolaryngology’s new Clinical Practice Guideline recommends acupuncture for patients with allergic rhinitis (AR) who are interested in non-pharmacological therapy (treatment without drugs).

A Guideline Development Group (20 experts in otolaryngology, allergy, immunology, nursing, CAM and consumer advocacy) developed the recommendations based on supporting evidence (randomised controlled trials with limitations, observational studies with consistent effects and a preponderance of benefit over harm).

Acupuncture was recognised as an effective alternative to medical therapies, which is associated with a reduction of symptoms and improved quality of life for patients. Its advantages were listed as including the avoidance of medication use (with its associated potential side-effects) and better alignment with patient values.

Their full statement on their conclusions about acupuncture for the treatment of allergic rhinitis is as follows:

  • STATEMENT 13. ACUPUNCTURE: Clinicians may offer acupuncture, or refer to a clinician who can offer acupuncture, for patients with allergic rhinitis who are interested in nonpharmacologic therapy. Option based on randomized controlled trials with limitations, observational studies with consistent effects, and a preponderance of benefit over harm.

Action Statement Profile

  • Quality improvement opportunity: Increased awareness of acupuncture as a treatment option for allergic rhinitis

  • Aggregate evidence quality: Grade B, based on randomized controlled trials with limitations, observational studies with consistent effects

  • Level of confidence in evidence: Low; the randomized trials did not show comparison to traditional medical therapy for allergic rhinitis and had methodological flaws

  • Benefits: Effective alternative to medical therapies, reduction of symptoms, may more closely align with patient values, improved quality of life, avoidance of medication use and potential side effects

  • Risks, harms, costs: Logistics of multiple treatments, need for multiple needle sticks, cost of treatment, rare infections

  • Benefit-harm assessment: Equilibrium of benefit and harm

  • Value judgments: Panel members varied in their preconceived bias for or against acupuncture

  • Intentional vagueness: None

  • Role of patient preferences: Limited—potential for shared decision making

  • Exclusions: None

  • Policy level: Option

  • Differences of opinions: None

Clinical practice guideline: allergic rhinitis executive summary. Otolaryngol Head Neck Surg. 2015 Feb;152(2):197-206.

A new meta-analysis of acupuncture for the treatment of allergic rhinitis.

A newly published meta-analysis of 13 papers (2365 participants) by Chinese authors further supports the use of acupuncture in allergic rhinitis, concluding that it can exert a significant reduction in nasal symptom scores, medication use and serum IgE levels, as well as an increase in quality of life compared with controls.

Acupuncture for the treatment of allergic rhinitis: a systematic review and meta-analysis. Am J Rhinol Allergy. 2015 Jan-Feb;29(1):57-62. doi: 10.2500/ajra.2015.29.4116.

 

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