Acupuncture works!

But not very well.

A randomized trial of acupuncture vs. sham acupuncture vs. nothing in treatment of osteoarthritis of the knee showed a significant improvement in pain and joint symptoms at 8 weeks for acupuncture itself.

That is the good news. The bad news is that the effect is lost after 8 weeks, calling its clinical importance into question. In addition, sham acupuncture (superficial needling of non-acupuncture points) was more effective than doing nothing, suggesting a strong effect of getting any treatment. As the accompanying commentary puts it:

The bottom line from Witt and colleagues’ large, long, and high-quality study of acupuncture for knee osteoarthritis is that doing something is better than doing nothing. The question is whether one sort of doing something is better than any other sort.

I've blogged previously on the need for rigourous trials of alternative and complementary approaches, and while acupuncture enthusiasts might see this trial as good news, the data suggest at most a more rapid improvement in the acupuncture group.

I also noted the negative trial of Echinacae on rhinovirus infection in the NEJM. Big surprise.

The accompanying editorial notes the resistance to logic among supporters of such supplements:

The Web page of a naturopathic organization that participated in a recent negative trial of echinacea² paraphrased the authors as follows: "Weber and the other researchers conclude that other echinacea preparations and dosing regimens may be effective for the treatment of colds, even though the product they tested in children was not."

which nicely points out the problem of those who "believe" no matter how much negative data accumulates.