Andreas Michalsen, MD; Stefanie Klotz, RN; Rainer Ldtke, PhD; Susanne Moebus, PhD, MPH; Gnther Spahn, MD; Gustav J. Dobos, MD
Grant Support: By a research grant from the Karl and Veronica Carstens Foundation, Essen, Germany.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Gustav J. Dobos, MD, Kliniken Essen-Mitte, Department of Internal Medicine V, Am Deimelsberg 34 a, 45276 Essen, Germany; e-mail, email@example.com.
Current Author Addresses: Drs. Michalsen, Spahn, and Dobos and Ms. Klotz: Kliniken Essen-Mitte, Department of Internal Medicine V, Am Deimelsberg 34 a, 45276 Essen, Germany.
Dr. Ldtke: Karl and Veronica Carstens Foundation, Am Deimelsberg 36, 45276 Essen, Germany.
Dr. Moebus: Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Essen, Hufelandstrasse 55, D-45147 Essen, Germany.
Author Contributions: Conception and design: A. Michalsen, R. Ldtke, G.J. Dobos.
Analysis and interpretation of the data: A. Michalsen, R. Ldtke, S. Moebus, G.J. Dobos.
Drafting of the article: A. Michalsen, G. Spahn.
Critical revision of the article for important intellectual content: S. Moebus, G. Spahn, G.J. Dobos.
Final approval of the article: A. Michalsen, G.J. Dobos.
Statistical expertise: R. Ldtke.
Obtaining of funding: G.J. Dobos.
Administrative, technical, or logistic support: A. Michalsen, S. Klotz, G. Spahn.
Collection and assembly of data: S. Klotz, S. Moebus.
Leech therapy was commonly used in traditional medicine for treating localized pain. Clinically significant pain relief after leech therapy for osteoarthritis of the knee has been demonstrated by preliminary data.
To evaluate the effectiveness of leech therapy for symptomatic relief of osteoarthritis of the knee.
Randomized, controlled trial.
Outpatient department for integrative medicine of an academic teaching hospital.
51 patients with osteoarthritis of the knee (leech therapy: 24 patients, mean age [SD], 62.5 10.2 years; topical diclofenac therapy: 27 patients, mean age [SD], 65.5 6.7 years).
A single treatment with 4 to 6 locally applied leeches (leech therapy group) or a 28-day topical diclofenac regimen (control group).
Mean of the pain, function, and stiffness subscores of the Western Ontario and McMaster Universities Osteoarthritis Index and physical sum score of the Medical Outcomes Study 36-Item Short-Form Health Survey with group comparisons at days 3, 7, 28, and 91.
The primary end point, pain at day 7, was reduced from a mean (SD) of 53.5 13.7 to 19.3 12.2 after leech therapy compared with 51.5 16.8 to 42.4 19.7 with topical diclofenac (estimated group difference, 23.9 [95% CI, 32.8 to 15.1]; P < 0.001). Although the difference between group pain scores was no longer significant after day 7, differences for function, stiffness, and total symptoms remained significant in favor of leech therapy until the end of study and for quality of life until day 28. Results were not affected by outcome expectation.
Leech therapy helps relieve symptoms in patients with osteoarthritis of the knee. The potential of leech therapy for treating osteoarthritis and the pharmacologic properties of leech saliva remain to be clarified.
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Michalsen A, Stefanie Klotz , Ldtke R, Moebus S, Spahn G, Dobos GJ. Effectiveness of Leech Therapy in Osteoarthritis of the Knee: A Randomized, Controlled Trial. Ann Intern Med. 2003;139:724–730. doi: 10.7326/0003-4819-139-9-200311040-00006
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Published: Ann Intern Med. 2003;139(9):724-730.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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