Table 1

Characteristics of included randomised controlled trials of bee venom acupuncture for rheumatoid arthritis

Lee et al34
MethodsDesign: prospective randomised controlled trial
Country: South Korea
Number of patients included (completed/randomised):
A. 37/40
B. 32/40
Mean age (years)
A. 49.2±9.6
B. 47.3±8.9
Duration of disease (years)(A) 9.2±7.0
(B) 7.3±4.6
Follow-up: 1 and 2 months
Intervention(A) BVA
(ashi points, acupoints near the inflammation point, two times a week for 2 months)
Control(B) Placebo
(normal saline injection on ashi points, acupoints near the inflammation point, two times a week for 2 months)
OutcomesPrimary outcomes
1. Morning stiffness, MD, −0.70 (−2.00 to 0.60), p<0.05
2. HAQ, MD, 0.00 (−0.08 to 0.08), p<0.05
3. VAS-pain, MD, −18.10 (−23.71 to −12.49), p<0.05
Secondary outcomes
1. Tender joint count, MD, −1.30 (−1.91 to −0.69), p<0.0001p<0.05
Secondary outcomes
2. Swollen joint count, MD, −1.10 (−1.72 to −0.48), p=0.005
3. ESR, MD, 20.10 (−22.80 to −17.40), p<0.00001
4. CRP, MD, −1.90 (−2.86 to −0.94), p=0.0001
NoteTreatment rationale: TKM theory, clinical experience
Adverse effect: NR
Funding: Korea Research Foundation Grant and Kyung Hee University
Language: Korean
Publication: full paper
Withdrawal/dropouts: yes
Intention-to-treat: no
Author comment: these results suggest that bee venom therapy could be an effective method in the treatment of patients with RA
Risk of bias
ItemAuthors’ judgementDescription
Random sequence generation (selection bias)Unclear riskDescribed as randomised but information not available
Allocation concealment (selection bias)Unclear riskNot stated
Blinding of participants and personnel (performance bias) all outcomesLow riskDescribed as double blinding
Blinding of outcome assessment (detection bias), all outcomesUnclear riskNot stated
Incomplete outcome data (attrition bias), all outcomesHigh riskData from 11 participants were not included in the analysis
Selective reporting (reporting bias)Low riskProtocol not available, but all expected outcomes reported
Other biasUnclear riskSmall sample size
  • BVA, bee venom acupuncture; CRP, C reactive protein; ESR, erythrocyte sedimentation rate; HAQ, health assessment questionnaire; MD, mean differences; NR, not reported; RA, rheumatoid arthritis; TKM, traditional Korean medicine; VAS, visual analogue scale.