Sociedad Americana de Hirudoterapia

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

Detalle de evidencia de RCTReferencia del ensayo
GRADE moderadaECACondición: Knee Osteoarthritis →
Tamaño de muestra de este ensayo en comparación con otros ensayos de Knee OsteoarthritisWang H 2018264Lauche R 2025240Lauche R 2014237Lauche R 2014237Farzali S 2025181Cui Y 2024144Andereya S 2008113Andereya S 2008113Isik M 201790Khoshnevisan A 202280
Este ensayo (destacado) por tamaño de muestra junto a otros ensayos indexados de Knee Osteoarthritis. Los ensayos más grandes generalmente tienen mayor peso estadístico.

Perfil del estudio

Diseño
systematic review and meta-analysis of randomized (3 RCTs) and nonrandomized (1 CCT) controlled trials
Tamaño de la muestra (n)
237
Intervención
Medical leech therapy as delivered in the included knee-osteoarthritis trials
Comparador
Control conditions of the included trials (topical NSAID, TENS, sham/placebo)
Punto final primario
Pain, functional impairment, and joint stiffness (standardized mean differences with 95% CI)
Resultado primario
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
Duración del seguimiento
per included trials (immediate to long-term windows)
PMID
23446069

Hallazgos clave

  • 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

Limitaciones

  • 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

Implicaciones clínicas

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.

Estudios relacionados

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)

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