Wei-Jen Chen1,2,3, Hanoch Livneh4, Chien-Hui Hsu5, Ying-To Hu6, Ning-Sheng Lai6,7, How-Ran Guo8,9,10, Tzung-Yi Tsai8,11,12. 1. Department of Chinese Medicine, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan. 2. School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan. 3. Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan. 4. Rehabilitation Counseling Program, Portland State University, Portland, OR, United States. 5. Department of Rehabilitation, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan. 6. Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan. 7. School of Medicine, Tzu Chi University, Hualien, Taiwan. 8. Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 9. Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. 10. Occupational Safety, Health, and Medicine Research Center, National Cheng Kung University, Tainan, Taiwan. 11. Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan. 12. Department of Medical Research, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
Abstract
Objectives: Women affected by rheumatoid arthritis (RA) have a higher risk of endometriosis, an estrogen-dependent, chronic inflammatory disease. Though acupuncture has long been a safe and effective therapy for treating inflammatory conditions, it is unclear whether it could prevent the onset of endometriosis. This study aims to determine the effect of acupuncture on the subsequent risk of endometriosis in female RA patients. Methods: Between 1998 and 2010, female subjects with RA were recruited from a nationwide database (5,736 patients; age ≥20 years). Enrolled patients included 2,407 acupuncture users and 2,407 nonusers randomly selected using propensity scores. The occurrence of endometriosis was recorded through the end of 2012. Cox proportional hazards regression was used to estimate the adjusted hazard ratio (HR) associated with acupuncture use. Results: During the follow-up period, 35 acupuncture users and 94 non-users developed endometriosis, with incidence rates of 2.36 and 4.91 per 1,000 person-years, respectively. Acupuncture use was associated with a 55% lower endometriosis risk (adjusted HR, 0.45; 95% confidence interval, 0.31-0.65). Those who received high intensity acupuncture (≥15 packages) had the greatest benefit. Conclusions: Findings suggest that adding acupuncture to conventional therapy may decrease the subsequent endometriosis risk in female RA patients. Prospective randomized trials are recommended to further clarify whether the association revealed in this study supports a causal link.
Objectives:Women affected by rheumatoid arthritis (RA) have a higher risk of endometriosis, an estrogen-dependent, chronic inflammatory disease. Though acupuncture has long been a safe and effective therapy for treating inflammatory conditions, it is unclear whether it could prevent the onset of endometriosis. This study aims to determine the effect of acupuncture on the subsequent risk of endometriosis in female RApatients. Methods: Between 1998 and 2010, female subjects with RA were recruited from a nationwide database (5,736 patients; age ≥20 years). Enrolled patients included 2,407 acupuncture users and 2,407 nonusers randomly selected using propensity scores. The occurrence of endometriosis was recorded through the end of 2012. Cox proportional hazards regression was used to estimate the adjusted hazard ratio (HR) associated with acupuncture use. Results: During the follow-up period, 35 acupuncture users and 94 non-users developed endometriosis, with incidence rates of 2.36 and 4.91 per 1,000 person-years, respectively. Acupuncture use was associated with a 55% lower endometriosis risk (adjusted HR, 0.45; 95% confidence interval, 0.31-0.65). Those who received high intensity acupuncture (≥15 packages) had the greatest benefit. Conclusions: Findings suggest that adding acupuncture to conventional therapy may decrease the subsequent endometriosis risk in female RApatients. Prospective randomized trials are recommended to further clarify whether the association revealed in this study supports a causal link.