Adverse events related to cupping therapy in studies conducted in Korea: A systematic review

Aims: To assess the adverse events (AEs) related to cupping therapy identified from studies conducted in Korea. Methods: Four Korean databases were searched from their inception to April 2013. We also searched PubMed and the Cochrane Library for literature from Korea. Regardless of the patient's condition, disease status, and study design, all studies were included in this review if they reported any AEs related to cupping therapy. If a case study was identified, causality was assessed through the WHO-UMC causality scale. In addition, if any randomized controlled trials (RCTs) were located, the quality of the reporting of AEs was evaluated. Results: Abstracts were retrieved for the 572 articles identified through the searches as having a relevant title which could be included in the review. Among them, a total of 16 studies were included in this review. Articles included various study designs; cross-sectional surveys, a prospective audit, case studies or series, and RCTs (or quasi-RCTs). Anemia (n=5), factitial panniculitis (n=2), and herpes viral infection (n=2) were the most frequently reported AEs in the observational studies. The results from the RCTs indicated that AEs related to cupping were infrequent. Conclusions: Various AEs related to cupping therapy were reported but were rare. Most of the AEs were avoidable, if trained personnel provided the treatment. Cupping should be administered by qualified medical experts and in compliance with safety guidelines. In addition, future clinical trials using cupping should pay more attention to recording AEs directly related to cupping to identify potential risks.