A pair of papers published recently in the Journal of Alternative and Complementary Medicine challenge the United Kingdom's NICE (National Institute for Health and Care Excellence) clinical practice guidelines for osteoarthritis of the knee, specifically the guideline's recommendation against the use of acupuncture as a treatment option for knee OA.

According to the abstract from the first paper,¹ authored by Stephen Birch, PhD, of Kristiania University College in Norway, and colleagues, "[I]t is argued that this NICE guideline has limitations that lead to several potential biases in its evaluation of acupuncture, which were not addressed correctly … If the same criteria and methods that have been applied to acupuncture were applied to other NICE-recommended therapies for knee OA, including patient centeredness, patient education, self-management and weight loss, nonsteroidal anti-inflammatory drug (NSAIDs), and cyclooxygenase-2 inhibitor (COX-2 inhibitors), these too would no longer be recommended and opiates would become the first line of drug prescription."

The title of the second paper, a commentary authored by Hugh MacPherson, PhD, Department of Health Sciences, University of York (U.K.), makes the author's issue with the NICE guideline abundantly clear: "NICE for Some Interventions, But Not So NICE for Others: Questionable Guidance on Acupuncture for Osteoarthritis and Low-Back Pain." Dr. MacPherson's commentary appears in the same issue as the Birch, et al., review.

Both papers are available online (for a fee) through the journal's publisher, Mary Ann Liebert, Inc.; John Weeks, editor-in-chief of the journal and editor / publisher of the Integrator Blog, also has an interesting piece on the topic (including the papers' mention in Popular Science) in Integrative Practitioner.²

References

1. Birch S, et al. The U.K. NICE 2014 guidelines for osteoarthritis of the knee: lessons learned in a narrative review addressing inadvertent limitations and bias. J Alt Comp Med, April 2017;23 (4).
2. Weeks J. "Marching for the Science of Acupuncture: Article Featured in Popular Science." Integrative Practitioner, May 16, 2017.

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