Effectiveness of medicinal leech therapy in moderate knee osteoarthritis: a pilot study
Zaidi SM, Jameel SS, Zaman F, Jilani S, Sultana A, Khan SA (2009) · Hindawi Journal of Evidence-Based Complementary & Alternative Medicine · n=30
Study Profile
- Design
- single-center, open-label, randomized pilot trial (Karachi)
- Sample size (n)
- 30
- Intervention
- Two sessions of 2-4 Hirudinaria granulosa leeches at the symptomatic knee, 14 days apart
- Comparator
- Diclofenac sodium 50mg twice daily for 4 weeks
- Primary endpoint
- WOMAC composite at week 4
- Primary result
- WOMAC composite improvement 56% in leech vs 39% in diclofenac at week 4 (p=0.04)
- Effect size (Cohen's d)
- 0.65
- Follow-up duration
- 8 weeks
Key Findings
- First Unani medicine RCT context for hirudotherapy
- Used H. granulosa (Indian/South Asian species)
- Effect emerged at week 2, peaked at week 4
- Comparator oral NSAID (diclofenac) more stringent than topical preparations
- Patient adherence to leech 100% — to NSAID 87%
Limitations
- Small sample (n=30)
- Open-label
- Single center, Unani medicine context
- Short follow-up (8 weeks)
- WOMAC not formally validated in Urdu
Clinical Implications
Zaidi 2009 is the first RCT-level evidence from a Unani medicine context. As with Karandikar 2018 (Ayurveda), the use of H. granulosa rather than H. medicinalis limits direct US clinical applicability. The trial primarily supports the species-agnostic effect hypothesis. For US clinicians, this trial is best treated as supporting evidence rather than primary citation.
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