Objective:

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To identify and synthesize the most recent available evidence of effectiveness of acupuncture on pain

physical function and health-related quality of life (HRQoL) in patients with rheumatoid arthritis (RA).

Methods:

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A comprehensive search of 12 Western and Chinese databases was undertaken from their inception up to end of 2016. Randomized controlled trials (RCTs)

concerning patients with RA treated with needle acupuncture

written in English

Portuguese

German or Chinese were included. Primary outcomes included pain

physical function and HRQoL. Secondary outcomes included morning stiffness

functional impairment

number of tender and swollen joints and serum concentrations of inflamatory markers. Methodological quality was assessed by three independent reviewers using the standardized critical appraisal instrument from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument.

Results:

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Twenty-two studies met the inclusion criteria. Of those

9 studies were excluded after assessment of their methodological quality. The remaining 13 original RCTs included 974 patients. Ten of these studies published in China

showed favorable statistical significant effects of acupuncture in relieving symptoms of RA compared with controls.

Conclusions:

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Evidence suggests that acupuncture interventions may have a positive effect in pain relief

physical function and HRQoL in RA patients. However

due to the heterogeneity and methodologic limitations of the studies included in this systematic review

evidence is not strong enough to produce a best practice guideline.