Acupuncture decreased the risk of stroke among patients with fibromyalgia in Taiwan: A nationwide matched cohort study

PLoS One. 2020 Oct 1;15(10):e0239703. doi: 10.1371/journal.pone.0239703. eCollection 2020.


Background: The aim of this study was to investigate the effectiveness of acupuncture in decreasing the risk of stroke in patients with fibromyalgia.

Methods: We enrolled patients who was newly diagnosed as having fibromyalgia between 1 January, 2000 and 31 December, 2010 from the Taiwanese National Health Insurance Research Database. The claim data for both the acupuncture cohort and non-acupuncture cohort were assessed from the index date to 31 December, 2013. A Cox regression model adjusted for age, sex, comorbidities, and drugs use was used to compare the hazard ratios of the two cohorts. The cumulative incidence of stroke was estimated by using the Kaplan-Meier method.

Results: After performing a propensity score matching with a 1:1 ratio, there were 65,487 patients in the acupuncture and non-acupuncture cohorts with similar distributions in the baseline characteristics. The cumulative incidence of stroke was significantly lower in the acupuncture cohort (log-rank test, p < 0.001). In the follow-up period, 4,216 patients in the acupuncture cohort (11.01 per 1000 person-years) and 6,849 patients in the non-acupuncture cohort (19.82 per 1000 person-years) suffered from stroke (adjusted HR 0.53, 95% CI 0.51-0.55). Acupuncture favorably affected the incidence of stroke regardless of the patient's age, sex, comorbidities, and conventional drug use.

Conclusions: Our study found that acupuncture might have a beneficial effect on reducing the risk of stroke in patients with fibromyalgia in Taiwan. Additional clinical and basic science studies are warranted.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acupuncture Therapy* / methods
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Female
  • Fibromyalgia / complications
  • Fibromyalgia / therapy*
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Factors
  • Sex Factors
  • Stroke / epidemiology
  • Stroke / etiology
  • Stroke / prevention & control*
  • Taiwan
  • Young Adult

Grants and funding

This study was supported in part by the “Chinese Medicine Research Center, China Medical University” from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education in Taiwan (CMRC-CHM-2)(HRY), by Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW109-TDU-B-212-114004) (HRY), by the health and welfare surcharge of tobacco products, China Medical University Hospital Cancer Research Center of Excellence (MOHW109-TDU-B-212-124024) (HRY); Ministry of Science and Technology (MOST 107-2320-B-039-037)(MFS), China Medical University Hospital (DMR-109-009)(MCH); (DMR-109-168)(MYW); (DMR-108-115) (HRY); (DMR-108-116) (HRY), and the Taiwan Ministry of Health and Welfare (M09G1025)(MCH). The funders played no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.