Researchers have launched a protocol for a systematic review and meta-analysis to assess the efficacy and safety of acupuncture in treating abdominal pain associated with immunoglobulin A vasculitis. They aim to synthesize existing evidence from randomized controlled trials to guide treatment decisions for this common complication. Though results are pending, prior studies suggest acupuncture may relieve abdominal pain more quickly than corticosteroids and reduce medication dependence, potentially though the release of endorphins and anti-inflammatory effects. These mechanisms, however, are not directly evaluated in the planned review.
The review will include randomized controlled trials (RCTs) of patients who are clinically diagnosed with immunoglobulin A vasculitis (IgAV) and abdominal pain. There are no restrictions based on age, sex, ethnicity, socioeconomic status, or geographic origin. Only studies published in English or Chinese will be included. Trials must use acupuncture as a standalone or combined treatment, and studies without outcome data, nonhuman studies, and nonfull-text articles will be excluded.
Lead author Peidong Zhao of the Henan University of Chinese Medicine in Zhengzhou, Henan, China, and colleagues will search eight databases—PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, China Biology Medicine, Wanfang Database, and Chinese Scientific Journal Database—up to June 1, 2025. Two reviewers will then independently screen and extract data, and a third will resolve disputes. Primary outcomes are symptom and sign scores, as well as time to disappearance of abdominal pain. Symptom scores (0, 2, 4, or 6) will assess abdominal pain, haematochezia, haematemesis, and intestinal wall edema, and a 0, 1, or 2 scale will score anorexia, abdominal distension and cutaneous purpura as secondart symptoms. Secondary outcomes will include recurrence rate, adverse events, and urinalysis results.
Data will be synthesized using Review Manager (RevMan) V.5.3. Standardized mean differences with 95% confidence intervals (CIs) will be used for continuous outcomes and relative risks with 95% CIs will be used for dichotomous outcomes. Risk of bias will be assessed using the Cochrane Risk of Bias 2.0 tool. Evidence quality will be rated using the GRADE approach. Subgroup and sensitivity analyses will address variations in treatment methods, duration, and study quality. Limiting inclusion to English and Chinese publications may cause relevant studies in other languages to be missed, the investigators noted. Underreporting of adverse events is also possible. Variability in acupuncture techniques and outcome measures may contribute to heterogeneity, but the researchers plan to conduct subgroup analyses based on treatment time, degree of pain, and acupuncture methods.
"Abdominal pain—occurring in 50–75% of cases—represents the most frequent gastrointestinal symptom," the authors wrote. They added, "Therefore, this study aims to rigorously assess the existing evidence regarding the efficacy and safety of acupuncture for managing IgAV-associated abdominal pain, with the ultimate goal of informing evidence-based clinical decision-making."
The authors reported no conflicts of interest.
Source: BMJ Open
