Disclosures: The authors report no relevant financial disclosures.
December 09, 2020
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Electroacupuncture shows promise in severe chronic constipation

Disclosures: The authors report no relevant financial disclosures.
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Electroacupuncture was non-inferior to Motegrity for the treatment of patients with severe chronic constipation, according to study results.

Zhishun Liu, MD, PhD, from the department of acupuncture and moxibustion at the China Academy of Chinese Medical Sciences, and colleagues wrote that acupuncture is used for several GI disorders, and previous research has shown it might be effective for constipation.

“Our previous trial indicated that 8-week electroacupuncture treatment was superior to sham electroacupuncture in increasing complete spontaneous bowel movements (CSBMs) in patients with severe chronic constipation with an excellent safety profile and sustainable effects,” they wrote. “As to the comparison of acupuncture with medical therapies for chronic constipation, the results were inconclusive based on the limited research evidence.”

Researchers recruited 560 patients with severe chronic constipation (defined by no more than two weekly CSBMs) and randomly assigned them to receive either 28 sessions of electroacupuncture over 8 weeks with follow-up and without treatment over 24 weeks (n = 280) or Motegrity (prucalopride, Takeda) for 32 weeks (n = 280).

The primary outcome of the study was the proportion of patients with at least three mean weekly CSBMs over weeks 3 to 8, based on the modified intention-to-treat population.

Liu and colleagues found that electroacupuncture was noninferior to prucalopride for the primary outcome (36.2% vs. 37.8%; P < .001 for noninferiority). They had similar findings in the per protocol analysis. Additionally, the proportions of CSBM responders through weeks 1 to 8 were similar in both groups (24.91% vs. 25.54%).

After the first 2 weeks of treatment, researchers found no difference between the groups in outcomes of excessive straining, stool consistency and quality of life.

Liu and colleagues found that just 17.69% of patients in the electroacupuncture group experienced adverse events compared with 44.24% in the prucalopride group. However, the only treatment-related adverse event occurred in the electroacupuncture group.

“Electroacupuncture and prucalopride had similar effects in relieving discomforts and improving quality of life in patients with severe chronic constipation,” Liu and colleagues wrote. “The effects of electroacupuncture could accumulate with 8-week treatments and sustain for 24 weeks after treatment. Electroacupuncture provides a promising noninferior alternative for severe chronic constipation.”