Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial
Michalsen A, Lüdtke R, Cesur Ö, Afra D, Musial F, Baecker M, Fink M, Dobos GJ (2008) · Pain · n=32
RCT evidence detailTrial reference
Study Profile
- Design
- randomized controlled trial (Kliniken Essen-Mitte, Essen, Germany)
- Sample size (n)
- 32
- Intervention
- Single treatment with 2-3 locally applied leeches (n=16)
- Comparator
- Topical diclofenac twice daily for 30 days (n=16)
- Primary endpoint
- Change in overall pain (mean VAS at rest, in motion and during grip) from baseline to day 7
- Primary result
- Overall pain at day 7 fell from 59.6 to 27.1 mm with leeches and from 50.6 to 46.9 mm with diclofenac (group difference -26.5 mm, 95% CI -40.3 to -12.7; p=0.0003); differences favouring leeches increased at days 30 and 60.
- Follow-up duration
- 60 days
- PMID
- 18407413
Key Findings
- Overall pain at day 7: 59.6 to 27.1 mm with leeches vs 50.6 to 46.9 mm with diclofenac (difference -26.5 mm, p=0.0003)
- The difference in pain relief favouring leeches increased at days 30 and 60
- Disability (DASH), quality of life (SF-36) and grip strength also improved significantly
- Results were not affected by outcome expectation or use of analgesics
Limitations
- Small sample (32 women)
- Women only
- Follow-up limited to 60 days
Clinical Implications
A single course of leech therapy relieved pain and improved disability and quality of life for at least two months in thumb-base osteoarthritis, compared with topical diclofenac. The authors call for further study of leech therapy for arthritic pain and of its mechanisms.