Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies.

Overview on risks of acupuncture-related adverse events (AEs). Systematic review and meta-analyses of prospective studies. PubMed, Scopus and Embase from inception date to 15 September 2019. Prospective studies assessing AEs caused by needle acupuncture in humans as primary outcome published in English or German. 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. Overall risk of minor AEs and serious adverse events (SAEs) per patients and per treatments. 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 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. CRD42020151930.

Informations de copyright

© 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.

Déclaration de conflit d'intérêts

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 Ärztegesellschaft für Akupunktur, DÄGfA, 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 DÄGfA. WZ and TS declare no other relationships or activities that could appear to have influenced the submitted work.