Two configurations of static magnetic fields for treating rheumatoid arthritis of the knee: A double-blind clinical trial

Vanderbilt University Medical School, Nashville, TN 37232, USA.
Archives of Physical Medicine and Rehabilitation (Impact Factor: 2.57). 10/2001; 82(10):1453-60. DOI: 10.1053/apmr.2001.24309
Source: PubMed


To assess the efficacy of a nonpharmacologic, noninvasive static magnetic device as adjunctive therapy for knee pain in patients with rheumatoid arthritis (RA).
Randomized, double-blind, controlled, multisite clinical trial.
An American and a Japanese academic medical center as well as 4 community rheumatology and orthopedics practices.
Cohort of 64 patients over age 18 years with rheumatoid arthritis and persistent knee pain, rated greater than 40/100mm, despite appropriate use of medications.
Four blinded MagnaBloc (with 4 steep field gradients) or control devices (with 1 steep field gradient) were taped to a knee of each subject for 1 week.
The American College of Rheumatology recommended core set of disease activity measures for RA clinical trials and subjects' assessment of treatment outcome.
Subjects randomly assigned to the MagnaBloc (n = 38) and control treatment groups (n = 26) reported baseline pain levels of 63/100mm and 61/100mm, respectively. A greater reduction in reported pain in the MagnaBloc group was sustained through the 1-week follow-up (40.4% vs 25.9%) and corroborated by twice daily pain diary results (p < .0001 for each vs baseline). However, comparison between the 2 groups demonstrated a statistically insignificant difference (p < .23). Subjects in the MagnaBloc group reported an average decrease in their global assessment of disease activity of 33% over 1 week, as compared with a 2% decline in the control group (p < .01). After 1 week, 68% of the MagnaBloc treatment group reported feeling better or much better, compared with 27% of the control group, and 29% and 65%, respectively, reported feeling the same as before treatment (p < .01).
Both devices demonstrated statistically significant pain reduction in comparison to baseline, with concordance across multiple indices. However, a significant difference was not observed between the 2 treatment groups (p < .23). In future studies, the MagnaBloc treatment should be compared with a nonmagnetic placebo treatment to characterize further its therapeutic potential for treating RA. This study did elucidate methods for conducting clinical trials with magnetic devices.

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Available from: Neil Segal, Sep 30, 2015
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    • "Together these represent favoured outcome measures for monitoring disease activity [49]. Results presented by Segal and colleagues appear to show that ESR may show wider variability [32], and therefore provide greater discriminative power in terms of detecting treatment effects. However plasma viscosity (PV) has now replaced ESR within the local region in which the CAMBRA trial will be conducted. "
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    ABSTRACT: Rheumatoid arthritis is a common inflammatory autoimmune disease. Although disease activity may be managed effectively with prescription drugs, unproven treatments such as magnet therapy are sometimes used as an adjunct for pain control. Therapeutic devices incorporating permanent magnets are widely available and easy to use. Magnets may also be perceived as a more natural and less harmful alternative to analgesic compounds. Of interest to health service researchers is the possibility that magnet therapy might help to reduce the economic burden of managing chronic musculoskeletal disorders. Magnets are extremely cheap to manufacture and prolonged treatment involves a single cost. Despite this, good quality scientific evidence concerning the safety, effectiveness and cost-effectiveness of magnet therapy is scarce. The primary aim of the CAMBRA trial is to investigate the effectiveness of magnet therapy for relieving pain and inflammation in rheumatoid arthritis. The CAMBRA trial employs a randomised double-blind placebo-controlled crossover design. Participant will each wear four devices: a commercially available magnetic wrist strap; an attenuated wrist strap; a demagnetised wrist strap; and a copper bracelet. Device will be allocated in a randomised sequence and each worn for five weeks. The four treatment phases will be separated by wash out periods lasting one week. Both participants and researchers will be blind, as far as feasible, to the allocation of experimental and control devices. In total 69 participants will be recruited from general practices within the UK. Eligible patients will have a verified diagnosis of rheumatoid arthritis that is being managed using drugs, and will be experiencing chronic pain. Outcomes measured will include pain, inflammation, disease activity, physical function, medication use, affect, and health related costs. Data will be collected using questionnaires, diaries, manual pill counts and blood tests. Magnetism is an inherent property of experimental devices which is hard to conceal. The use of multiple control devices, including a copper bracelet, represents a concerted attempt to overcome methodological limitations associated with trials in this field. The trial began in July 2007. At the time of submission (August 2008) recruitment has finished, with 70 trial participants, and data collection is almost complete. Current Controlled Trials ISRCTN51459023.
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    • "stimulation. A series of studies suggest the promise of this procedure,25-27 as do other approaches to manipulating low-level magnetic fields with alterations of the parameters of magnetic resonance spectroscopic imaging (MRSI).28 Should rTMS and these lesser invasive techniques of DC stimulation and low-level magnetic fields prove useful in preliminary controlled studies, further intensive study would appear warranted in light, of their convenience and apparent safety. "
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    • "Stationary magnets have been studied for pain of many different body areas, with varying reports of benefit. A summary of success from a number of different studies has been reported in the treatment of knee pain, chronic pelvic pain, postpolio pain, and carpal tunnel pain [69] [70] [71] [72] [73]. Little to no benefit was found in treating wrist pain, fibromyalgia, and low back pain, and no benefit in treating heel pain associated with plantar fascitis [74] [75] [76] [77]. "
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