Acupuncture for gouty arthritis A PRISMA-compliant protocol for a systematic review and meta-analysis of randomized controlled trials

Backgroud: Patients with gouty arthritis suffer from intermittent attacks of pain, chronic inflammation, and joint damage. Acupuncture has been used in East Asian countries for centuries to treat various diseases, and several clinical studies have reported that acupuncture has beneficial effects on gouty arthritis. This study aims to evaluate the effect of acupuncture in patients with gouty arthritis by conducting a systematic review and meta-analysis. Methods: A comprehensive search of 8 electronic databases will be performed, including MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, 4 Korean databases (KoreaMed, Korean Studies Information Service System, Research Information Service System, and Oriental Medicine Advanced Searching Integrated System), and 1 Chinese database (China National Knowledge Infrastructure). Only randomized controlled trials comparing acupuncture to conventional treatment and acupuncture with conventional treatment to conventional treatment alone for gouty arthritis will be included. Pain intensity will be considered the primary outcome. The secondary outcomes will include the pain relief duration, total effective rate, blood uric acid level, inflammatory markers, and incidence of adverse events. Two independent researchers will perform the study selection, data extraction, and quality assessment. The methodological quality of the individual included studies will be assessed using the Cochrane risk of bias tool. In the meta-analysis, for dichotomous and continuous data, risk ratios and standardized mean differences, respectively, will be estimated in addition to 95% confidence intervals. Results : This systematic review will evaluate the effect of acupuncture treatment for patients with gouty arthritis with respect to clinical symptoms, laboratory indicators, and safety. Conclusion : Our findings will help to establish the evidence of acupuncture to treat gouty arthritis. Registration number: PROSPERO CRD42020169668.