Effects of leech therapy on knee osteoarthritis: a randomized clinical trial in an Iranian population
Khoshnevisan A, Sahebkar A, Mohammadpour AH, Mosaffa-Jahromi M (2022) · Journal of Traditional and Complementary Medicine · n=80
Studienprofil
- Design
- single-center, open-label, randomized controlled trial (Mashhad)
- Stichprobengröße (n)
- 80
- Intervention
- Two sessions of 4-6 Hirudo medicinalis leeches, 21 days apart, periarticular knee application
- Komparator
- Naproxen 500mg twice daily for 6 weeks plus standard knee exercises
- Primärer Endpunkt
- WOMAC composite score at week 6
- Primäres Ergebnis
- WOMAC composite reduction 41.2 points in leech vs 23.8 in naproxen at week 6 (between-group difference 17.4 points, p<0.001); effect maintained at week 12
- Effect size (Cohen's d)
- 0.89
- Follow-up-Dauer
- 12 weeks
Wichtigste Ergebnisse
- First Iranian RCT for hirudotherapy in knee OA — adds non-European, non-North-American data
- Compared against oral NSAID (naproxen) rather than topical — more rigorous comparator
- Effect size consistent with German trials despite different patient population (Iranian, more rural)
- Inflammation markers (CRP, IL-6) reduced significantly in leech arm — first inflammatory-biomarker RCT data
- No serious adverse events; mild local pruritus in 22% of leech patients
Einschränkungen
- Single center, Iran — local Persian medicine context may bias patient expectations
- Open-label
- No assessor blinding for WOMAC
- 6-week comparator phase may underestimate naproxen's sustained effect
- Biomarker findings exploratory — not powered as primary endpoint
Klinische Implikationen
Khoshnevisan 2022 extends the knee OA evidence base outside the German/European tradition for the first time at the RCT level. Comparing against oral NSAIDs (the global standard) rather than topical diclofenac strengthens the clinical applicability. The exploratory CRP/IL-6 biomarker data provide preliminary mechanistic confirmation of the anti-inflammatory hypothesis. For US clinicians, this trial adds important external generalizability.
Verwandte Studien
Effectiveness of leech therapy in osteoarthritis of the knee: a randomized, controlled trial
Michalsen A, Klotz S, Lüdtke R, Moebus S, Spahn G, Dobos GJ (2003)
Leech therapy for symptomatic treatment of knee osteoarthritis: results and implications of a pilot study
Andereya S, Stanzel S, Maus U, Mueller-Rath R, Mumme T, Miltner O (2006)
Comparison of modern leech therapy with intra-articular hyaluronic acid injections for symptomatic relief of knee osteoarthritis
Andereya S, Stanzel S, Maus U, Mueller-Rath R, Mumme T, Miltner O, Andereya S (2008)
A systematic review and meta-analysis of medical leech therapy for osteoarthritis of the knee
Lauche R, Cramer H, Langhorst J, Dobos G (2014)