Differential placebo effect of sham acupuncture for chronic pain: a network meta-analysis of randomized controlled trials
Abstract
Background: The clinical effects of acupuncture are often underestimated due to the placebo effect of sham acupuncture. While multiple sham acupuncture methods have been used in clinical practice, it is challenging to select the appropriate sham acupuncture technique due to the lack of head-to-head trials.
Purpose: The purpose of this study was to compare the differential placebo effects of diverse sham acupuncture interventions, providing evidence-based guidance for selecting optimal placebo controls in clinical practice.
Method: PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science were systematically searched for randomized controlled trials comparing acupuncture with sham acupuncture for the treatment of chronic non-cancer pain (from inceptions to May 1, 2025). The primary outcome measure was pain variation, while secondary outcome measures included adverse events and the assessment of acupuncture blinding. Frequentist random-effect models were employed to perform indirect treatment comparison meta-analysis, and Confidence in Network Meta-Analysis (CINeMA) was utilized to evaluate the level of evidence.
Results: A total of 45 randomized controlled trials (RCTs) were included, involving 7 sham acupuncture methods and 8287 participants. Regarding pain variation, the difference was noted between the waiting treatment group (mean difference 1.86 (95% confidence interval 1.36 to 2.35), SUCRA 97.4%; moderate confidence of evidence) and manual…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 8,287 participants or records.
Read the paper
Related studies
- Calcium Ions in the Physiology and Pathology of the Central Nervous System
- AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare
- In silico functional, structural and pathogenicity analysis of missense single nucleotide polymorphisms in human MCM6 gene
- In Silico drug repurposing pipeline using deep learning and structure based approaches in epilepsy
- Targeting serotonin receptors with phytochemicals – an in-silico study
- In silico exploration of anti-prostate cancer compounds from differential expressed genes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.