Leech Therapy for Thumb Osteoarthritis — RCT

Leech therapy has been shown to be effective for symptomatic treatment of osteoarthritis of the knee. We aimed to investigate the effectiveness of leech therapy in another type of osteoarthritis, osteoarthritis of the first carpometacarpal joint (thumb saddle joint). Thirty-two women with symptomatic painful osteoarthritis of the first carpometacarpal joint and who scored>40 mm on a 100mm VAS pain scale were randomized to a single treatment with 2-3 locally applied leeches (leech group) or a 30-day course with topical diclofenac twice a day. Primary outcome measure was change of overall pain (mean of VAS for pain at rest, in motion, during grip) from baseline to day 7. Secondary outcomes were functional disability (DASH-questionnaire), quality of life (QoL, SF-36) and grip strength. Patients were examined baseline and at days 7, 30 and 60 after treatment. Overall pain score at day 7 was reduced from 59.6+/-13.8 to 27.1+/-20.6 in the leech group (n=16) and from 50.6+/-13.3 to 46.9+/-18.5 with diclofenac (n=16) (group difference -26.5, 95%CI -40.3; -12.7; p=0.0003). Group differences for pain relief favoring the leech treatment increased at days 30 and 60. Significant treatment effects were also observed for the DASH score, QoL and grip. Results were not affected by outcome expectation or consumption of analgetics. A single course of leech therapy is effective in relieving pain, improving disability and QoL for at least 2 months. The potential of leech therapy for treatment of arthritic pain and underlying mechanisms should be further investigated.

Resumen tomado de PubMed (NCBI) para el registro citado, en el idioma original. La versión de referencia es la de la publicación original.

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Randomized controlled trial of leech therapy versus topical diclofenac for symptomatic osteoarthritis of the thumb (first carpometacarpal joint). In 32 women (16 per group), a single treatment with 2–3 locally applied leeches reduced overall pain at day 7 from 59.6 to 27.1, versus 50.6 to 46.9 with a 30-day course of topical diclofenac twice a day (group difference −26.5, 95% CI −40.3 to −12.7; p=0.0003); group differences favoring leech treatment increased at days 30 and 60, and significant effects were also seen for the DASH disability score, quality of life and grip strength, extending the evidence base for hirudotherapy beyond the knee to the thumb saddle joint.

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