Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2003; 8: 150–1
To examine whether leeches therapy is more efficacious than topical diclofenac treatment in knee osteoarthritis (OA).
Patients (age 40–85, body mass index < 35 kg/m2) with primary knee OA and radiographic stadium Kellgren and Lawrence II–III were eligible. Major exclusion criteria were treatment with anticoagulants or haemophilic disorder, presence of other rheumatic diseases, and insulin-dependent diabetes mellitus. Patients were randomised into verum or control group and followed up for 3 months. Verum patients were treated once with four to six leeches applied topically at periarticular sites at the painful knee joint. Control patients were treated with topical diclofenac lotion twice a day. The change (days 0–7) of the WOMAC OA index pain subscale was defined as the main outcome criterion.
Fifty-one patients were randomised. Both groups were comparable with respect to age and baseline WOMAC scores. The WOMAC pain subscale indicated significant benefit for the verum group over diclofenac: diclofenac patients improved by 1.0 but verum patients by 3.4 score points (estimated group difference 2.2 points; 95% confidence interval 1.4–3.2; P = 0.0001, analysis of covariance). Results are similar to the WOMAC subscales for stiffness and physical function. Data on long-term effects are not yet available but will be presented at the conference.
We found an overwhelming pain relieving effect with leech therapy. A variety of pharmacological substances in leech salvia (but also counter-irritation and non-specific effects) could be responsible for the observed pain reduction.
