A systematic review and meta-analysis of medical leech therapy for osteoarthritis of the knee
Lauche R, Cramer H, Langhorst J, Dobos G (2014) · The Clinical Journal of Pain · n=237
RCT-EvidenzdetailsStudienreferenz
Studienprofil
- Design
- systematic review and meta-analysis of randomized (3 RCTs) and nonrandomized (1 CCT) controlled trials
- Stichprobengröße (n)
- 237
- Intervention
- Medical leech therapy as delivered in the included knee-osteoarthritis trials
- Komparator
- Control conditions of the included trials (topical NSAID, TENS, sham/placebo)
- Primärer Endpunkt
- Pain, functional impairment, and joint stiffness (standardized mean differences with 95% CI)
- Primäres Ergebnis
- Strong evidence for immediate (SMD -1.05, P<0.01) and short-term pain reduction (SMD -1.00, P<0.01); immediate improvement in physical function (SMD -0.72, P<0.01); immediate (SMD -0.88, P=0.04) and long-term joint-stiffness improvement (SMD -0.62, P<0.01); moderate evidence for short-term function (SMD -0.46) and long-term pain (SMD -0.45)
- Effect size (Cohen's d)
- 1.05
- Follow-up-Dauer
- per included trials (immediate to long-term windows)
- PMID
- 23446069
Wichtigste Ergebnisse
- Three RCTs and one CCT pooled (237 patients); three trials rated low risk of bias
- Strong evidence for immediate (SMD -1.05) and short-term (SMD -1.00) pain reduction
- Immediate improvement in physical function (SMD -0.72) and joint stiffness (SMD -0.88)
- Long-term improvements in stiffness (SMD -0.62) and pain (SMD -0.45)
- No serious adverse events reported across the included trials
Einschränkungen
- Only four controlled trials existed as of the August 2012 search
- Included trials were open-label; no blinded sham comparison available
- Authors call for further high-quality RCTs before conclusive judgment
Klinische Implikationen
This meta-analysis aggregates Michalsen 2003, Andereya 2008, and the other controlled knee-OA data into pooled effect sizes, providing the quantitative backbone for the moderate-evidence grading of leech therapy in knee osteoarthritis. It adds no new trial cohort of its own.
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)
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)