A Randomized, Placebo-Controlled Trial of Acupuncture in Patients With Chronic Obstructive Pulmonary Disease (COPD): The COPD-Acupuncture Trial (CAT) | Chronic Obstructive Pulmonary Disease | JAMA Internal Medicine | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
Global Initiative for Chronic Obstructive Lung Disease.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease updated 2009. http://www.goldcopd.org/Guidelineitem. Accessed January 11, 2010
Mahler DA, Tomlinson D, Olmstead EM, Tosteson AN, O’Connor GT. Changes in dyspnea, health status, and lung function in chronic airway disease.  Am J Respir Crit Care Med. 1995;151(1):61-657812573PubMedGoogle Scholar
Cohen AJ, Menter A, Hale L. Acupuncture: role in comprehensive cancer care—a primer for the oncologist and review of the literature.  Integr Cancer Ther. 2005;4(2):131-14315911926PubMedGoogle ScholarCrossref
Jobst KA. A critical analysis of acupuncture in pulmonary disease: efficacy and safety of the acupuncture needle.  J Altern Complement Med. 1995;1(1):57-859395603PubMedGoogle ScholarCrossref
Suzuki M, Namura K, Ohno Y,  et al.  The effect of acupuncture in the treatment of chronic obstructive pulmonary disease.  J Altern Complement Med. 2008;14(9):1097-110519055335PubMedGoogle ScholarCrossref
Brooks SM. Surveillance for respiratory hazard.  ATS News. 1982;8:12-16Google Scholar
Park J, White A, Stevinson C, Ernst E, James M. Validating a new non-penetrating sham acupuncture device: two randomised controlled trials.  Acupunct Med. 2002;20(4):168-17412512790PubMedGoogle ScholarCrossref
Couser JI Jr, Guthmann R, Hamadeh MA, Kane CS. Pulmonary rehabilitation improves exercise capacity in older elderly patients with COPD.  Chest. 1995;107(3):730-7347874945PubMedGoogle ScholarCrossref
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories.  ATS statement: guidelines for the six-minute walk test.  Am J Respir Crit Care Med. 2002;166(1):111-11712091180PubMedGoogle Scholar
Borg GA. Psychophysical bases of perceived exertion.  Med Sci Sports Exerc. 1982;14(5):377-3817154893PubMedGoogle Scholar
American Thoracic Society.  Standardization of spirometry, 1994 update.  Am J Respir Crit Care Med. 1995;152(3):1107-11367663792PubMedGoogle Scholar
Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A self-complete measure of health status for chronic airflow limitation: the St George's Respiratory Questionnaire.  Am Rev Respir Dis. 1992;145(6):1321-13271595997PubMedGoogle Scholar
American Thoracic Society/European Respiratory Society.  ATS/ERS Statement on respiratory muscle testing.  Am J Respir Crit Care Med. 2002;166(4):518-62412186831PubMedGoogle ScholarCrossref
Calverley PM. Minimal clinically important difference: exacerbations of COPD.  COPD. 2005;2(1):143-14817136975PubMedGoogle ScholarCrossref
Jobst K, Chen JH, McPherson K,  et al.  Controlled trial of acupuncture for disabling breathlessness.  Lancet. 1986;2(8521-22):1416-14192878274PubMedGoogle ScholarCrossref
Lewith GT, Prescott P, Davis CL. Can a standardized acupuncture technique palliate disabling breathlessness? a single-blind, placebo-controlled crossover study.  Chest. 2004;125(5):1783-179015136391PubMedGoogle ScholarCrossref
Wise RA, Brown CD. Minimal clinically important differences in the six-minute walk test and the incremental shuttle walking test.  COPD. 2005;2(1):125-12917136972PubMedGoogle ScholarCrossref
Ries AL. Minimally clinically important difference for the UCSD Shortness of Breath Questionnaire, Borg scale, and visual analog scale.  COPD. 2005;2(1):105-11017136970PubMedGoogle ScholarCrossref
Sciurba F, Criner GJ, Lee SM,  et al; National Emphysema Treatment Trial Research Group.  Six-minute walk distance in chronic obstructive pulmonary disease: reproducibility and effect of walking course layout and length.  Am J Respir Crit Care Med. 2003;167(11):1522-152712615634PubMedGoogle ScholarCrossref
O’Donnell DE, Banzett RB, Carrieri-Kohlman V,  et al.  Pathophysiology of dyspnea in chronic obstructive pulmonary disease: a roundtable.  Proc Am Thorac Soc. 2007;4(2):145-16817494725PubMedGoogle ScholarCrossref
Kawakita K, Itoh K, Okada K. Experimental model of trigger points using eccentric exercise.  J Musculoskeletal Pain. 2008;16:29-35Google ScholarCrossref
Burnstock G. Acupuncture: a novel hypothesis for the involvement of purinergic signalling.  Med Hypotheses. 2009;73(4):470-47219628336PubMedGoogle ScholarCrossref
Jones PW. St George's Respiratory Questionnaire: MCID.  COPD. 2005;2(1):75-7917136966PubMedGoogle ScholarCrossref
Hajiro T, Nishimura K, Tsukino M, Ikeda A, Oga T. Stages of disease severity and factors that affect the health status of patients with chronic obstructive pulmonary disease.  Respir Med. 2000;94(9):841-84611001074PubMedGoogle ScholarCrossref
Lacasse Y, Goldstein R, Lasserson TJ, Martin S. Pulmonary rehabilitation for chronic obstructive pulmonary disease.  Cochrane Database Syst Rev. 2006;(4):CD00379317054186PubMedGoogle Scholar
Schols AM, Slangen J, Volovics L, Wouters EF. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease.  Am J Respir Crit Care Med. 1998;157(6 pt 1):1791-17979620907PubMedGoogle Scholar
Celli BR, Cote CG, Marin JM,  et al.  The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease.  N Engl J Med. 2004;350(10):1005-101214999112PubMedGoogle ScholarCrossref
Creutzberg E. Anabolic steroids in acute and chronic disease. In: Wouters EFM, Schols AMWJ, eds. Nutrition and Metabolism in Chronic Respiratory Disease [European respiratory monograph]. Lausanne, Switzerland: European Respiratory Society Journals Ltd; 2003
Takahashi T. Acupuncture for functional gastrointestinal disorders.  J Gastroenterol. 2006;41(5):408-41716799881PubMedGoogle ScholarCrossref
Original Investigation
June 11, 2012

A Randomized, Placebo-Controlled Trial of Acupuncture in Patients With Chronic Obstructive Pulmonary Disease (COPD): The COPD-Acupuncture Trial (CAT)

Author Affiliations

Author Affiliations: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto (Drs M. Suzuki, Muro, Sato, and Mishima), Division of Respiratory Medicine, Respiratory Disease Center Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka (Drs M. Suzuki, Aihara, Matsumoto, S. Suzuki, Itotani, Ishitoko, Takemura, Ueda, Kagioka, and Fukui), Biostatistics Group, Center for Product Evaluation, Pharmaceuticals and Medical Devices Agency, Tokyo (Ms Ando), Epidemiology and Biostatistics Laboratory, Faculty of Culture and Information Science, Doshisha University, Kyoto (Dr Omori), Department of Respiratory Medicine, Ako City Hospital, Ako City (Dr Shiota), Department of Respiratory Medicine, Hyogo Prefectural Amagasaki Hospital, Hyogo (Drs Endo, Hara, and Hirabayashi), and Department of Clinical Acupuncture and Moxibustion, Meiji University of Integrative Medicine, Kyoto (Dr M. Suzuki), Japan.

Arch Intern Med. 2012;172(11):878-886. doi:10.1001/archinternmed.2012.1233

Background Dyspnea on exertion (DOE) is a major symptom of chronic obstructive pulmonary disease (COPD) and is difficult to control. This study was performed to determine whether acupuncture is superior to placebo needling in improving DOE in patients with COPD who are receiving standard medication.

Methods Sixty-eight of 111 patients from the Kansai region of Japan who were diagnosed as having COPD and were receiving standard medication participated in a randomized, parallel-group, placebo-controlled trial (July 1, 2006, through March 31, 2009) in which the patients, evaluators, and statistician were unaware of the random allocation. Participants were randomly assigned to traditional acupuncture (real acupuncture group, n = 34) or placebo needling (placebo acupuncture group, n = 34). Both groups received real or placebo needling at the same acupoints once a week for 12 weeks. The primary end point was the modified Borg scale score evaluated immediately after the 6-minute walk test. Measurements were obtained at baseline and after 12 weeks of treatment.

Result After 12 weeks, the Borg scale score after the 6-minute walk test was significantly better in the real acupuncture group compared with the placebo acupuncture group (mean [SD] difference from baseline by analysis of covariance, −3.6 [1.9] vs 0.4 [1.2]; mean difference between groups by analysis of covariance, −3.58; 95% CI, −4.27 to −2.90). Patients with COPD who received real acupuncture also experienced improvement in the 6-minute walk distance during exercise, indicating better exercise tolerance and reduced DOE.

Conclusion This study clearly demonstrates that acupuncture is a useful adjunctive therapy in reducing DOE in patients with COPD.

Trial Registration umin.ac.jp/ctr Identifier: UMIN000001277