Observation on Clinical Efficacy and Safety of Acupuncture Combined With Leflunomide in the Treatment of Rheumatoid Arthritis

Abstract

Objective

To evaluate the clinical efficacy and safety of acupuncture combined with leflunomide in the treatment of rheumatoid arthritis (RA).

Methods

A total of 104 outpatients with active RA were selected from our hospital. Based on their actual treatment regimens in the outpatient clinic, they were divided into the leflunomide + acupuncture group and leflunomide group, with 52 cases in each group. The leflunomide group was treated with leflunomide alone, and the leflunomide + acupuncture group was treated with acupuncture combined with leflunomide. The main efficacy indicators were the change in 28-joint Disease Activity Score (DAS28) and the response rate of the American College of Rheumatology (ACR) 20, ACR50, and ACR70. Secondary efficacy indicators included the visual analog scale (VAS), morning stiffness time, and Health Assessment Questionnaire (HAQ) score. The safety indices included the occurrence of adverse reactions and changes in laboratory indices.

Results

There was no significant difference in general data, disease activity index, and laboratory index between the two groups (P > 0.05). The DAS28 scores of the two groups were significantly lower than the baseline after 1 month and 3 months of treatment (P < 0.001), and the decrease in the leflunomide + acupuncture group was significantly greater than that in the leflunomide group (P < 0.05). The rate of ACR50 in the leflunomide + acupuncture group was 46.2% at 1 month of treatment. It was significantly better than 26.9% in the leflunomide group (P < 0.05). The rates of ACR20 and ACR50 in the leflunomide + acupuncture group were 82.7% and 57.7% at 3 months of treatment, respectively, which were significantly better than 65.4% and 36.5% in the leflunomide group (P < 0.05). The VAS score, morning stiffness time, and HAQ score in the leflunomide + acupuncture group were significantly lower than those in the leflunomide group three months after treatment (all P < 0.05). The comparison of the incidence of adverse reactions between the two groups showed no statistically significant difference (P > 0.05). The reduction in inflammatory factors (ESR, CRP) in the leflunomide + acupuncture group was significantly greater than that in the leflunomide group (P < 0.05), while liver and kidney function indicators showed no significant abnormalities.

Conclusion

In routine clinical practice, acupuncture combined with leflunomide was associated with greater improvements in disease activity and clinical symptoms in patients with RA, without increasing adverse events. It provides real-world evidence for clinical application, and the long-term efficacy and safety are needed to verify.