The Efficacy and Safety of Acupuncture on Xerostomia in Patients with Sjogren’s Syndrome: A Systematic Review and Network Meta-analysis Protocol

Abstract

Background Previous researches in Sjogren’s syndrome (SS) have showed that acupuncture has effectiveness in alleviating xerostomia and clinical symptoms. While other studies held different viewpoints and results. Therefore, a systematic review and meta-analysis should be conducted to evaluate its efficacy on xerostomia in SS patients. Methods and analysis: 8 databases will be retrieved from inception to February 20, 2023. They are China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP database, Chinese Biomedical Literature Database (CBM/SinoMed), Embase, PubMed, Cochrane Library and Web of Science. The languages are restricted to Chinese and English. Only randomized controlled trials (RCT) of acupuncture on SS patients will be included. The data screening, extraction and assessment of risk of bias (ROB) will be conducted by 2 researchers individually. The GRADE assessment will be used to evaluate the quality of evidence. The RevMan V.5.3 software will help with pairwise meta-analysis and ADDIS software with network meta-analysis. Moreover, meta-regression and subgroup analysis will be performed to discuss the possible underlying causes of heterogeneity. The primary outcome is the change of xerostomia symptoms. The secondary outcomes include changes in salivary flow, quality of life, oral health, ESSPRI index, ESSDAI index, inflammation severeness and adverse effects. Results This systematic review and network meta-analysis will demonstrate how well acupuncture treats xerostomia in SS patients compared with placebo or other interventions. Ethics and dissemination: Ethical approval is not applicable and the results will be peer-reviewed and published in a journal. Trial registration number: CRD42023398003