Effectiveness and safety of bee venom pharmacopuncture for rheumatoid arthritis-related pain and disease activity: a systematic review and meta-analysis.
4 affiliations
- 1Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Sangji University, Wonju-si, Republic of Korea.
- 2Department of Acupuncture and Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
- 3Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, Republic of Korea.
- 4Research Institute of Korean Medicine, Sangji University, Wonju-si, Republic of Korea.
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint pain, inflammation, and progressive joint destruction. Bee venom (BV) pharmacopuncture has been used in East Asia for RA, but its clinical effectiveness and safety remains uncertain. We evaluated BV pharmacopuncture for pain, disease activity, treatment response, and adverse events (AEs) in patients with RA. We systematically searched PubMed, the Cochrane Library, Embase, SciELO, CNKI, CiNii, KISS, and other regional databases for randomized controlled trials (RCTs). Risk of bias was assessed using RoB 2, meta-analyses were conducted using RevMan 5.4, and the certainty of evidence was evaluated using GRADE. Seventeen RCTs involving 1,304 patients with RA were included, and 14 contributed to meta-analysis. Compared with Western medicine, BV significantly improved pain-related outcomes as monotherapy (standardized mean difference [SMD] -0.99, 95% confidence interval [CI] -1.37 to -0.60; I2 = 20%) and add-on therapy (SMD -1.14, 95% CI -2.11 to -0.17; I2 = 93%). Only one study evaluated disease activity using the Disease Activity Score in 28 joints based on the erythrocyte sedimentation rate and reported a significant benefit with BV. Although most other disease activity-related outcomes favored BV, the overall effect remained uncertain because the evidence was limited and heterogeneous. BV improved the response rate, defined as a ≥ 30% improvement, as add-on therapy (risk ratio [RR] 1.18, 95% CI 1.03 to 1.36; I2 = 9%), but not in direct comparisons with Western medicine (RR 1.07, 95% CI 1.00 to 1.16; I2 = 0%; p = 0.06). The risk of AEs was relatively low with BV monotherapy (risk difference [RD] -0.17, 95% CI -0.34 to -0.01; I2 = 37%) and add-on comparisons (RD = -0.16, 95% CI -0.26 to -0.06; I2 = 0%). No serious BV-related AEs, including anaphylaxis, were reported. BV pharmacopuncture may improve pain and treatment response in RA without increasing the risk of AEs. However, these findings are supported by low certainty of evidence, and the effect on disease activity remains uncertain. Further high-quality RCTs with standardized treatment protocols and validated outcome measures are warranted to establish its clinical efficacy and safety. https://www.crd.york.ac.uk/PROSPERO/view/CRD42021238058, PROSPERO CRD42021238058.
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BibTeX
@article{hong2026effectiveness,
title = {{Effectiveness and safety of bee venom pharmacopuncture for rheumatoid arthritis-related pain and disease activity: a systematic review and meta-analysis.}},
author = {Jinyeong Hong and Won-Suk Sung and Eun-Jung Kim and Byung-Kwan Seo and Joo-Hee Kim},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1954842},
url = {https://europepmc.org/article/MED/42952787},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effectiveness and safety of bee venom pharmacopuncture for rheumatoid arthritis-related pain and disease activity: a systematic review and meta-analysis.
AU - Jinyeong Hong
AU - Won-Suk Sung
AU - Eun-Jung Kim
AU - Byung-Kwan Seo
AU - Joo-Hee Kim
PY - 2026
DA - 2026/10/14
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1954842
UR - https://europepmc.org/article/MED/42952787
AB - Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint pain, inflammation, and progressive joint destruction. Bee venom (BV) pharmacopuncture has been used in East Asia for RA, but its clinical effectiveness and safety remains uncertain. We evaluated BV pharmacopuncture for pain, disease activity, treatment response, and adverse events (AEs) in patients with RA. We systematically searched PubMed, the Cochrane Library, Embase, SciELO, CNKI, CiNii, KISS, and other regional databases for randomized controlled trials (RCTs). Risk of bias was assessed using RoB 2, meta-analyses were conducted using RevMan 5.4, and the certainty of evidence was evaluated using GRADE. Seventeen RCTs involving 1,304 patients with RA were included, and 14 contributed to meta-analysis. Compared with Western medicine, BV significantly improved pain-related outcomes as monotherapy (standardized mean difference [SMD] -0.99, 95% confidence interval [CI] -1.37 to -0.60; I2 = 20%) and add-on therapy (SMD -1.14, 95% CI -2.11 to -0.17; I2 = 93%). Only one study evaluated disease activity using the Disease Activity Score in 28 joints based on the erythrocyte sedimentation rate and reported a significant benefit with BV. Although most other disease activity-related outcomes favored BV, the overall effect remained uncertain because the evidence was limited and heterogeneous. BV improved the response rate, defined as a ≥ 30% improvement, as add-on therapy (risk ratio [RR] 1.18, 95% CI 1.03 to 1.36; I2 = 9%), but not in direct comparisons with Western medicine (RR 1.07, 95% CI 1.00 to 1.16; I2 = 0%; p = 0.06). The risk of AEs was relatively low with BV monotherapy (risk difference [RD] -0.17, 95% CI -0.34 to -0.01; I2 = 37%) and add-on comparisons (RD = -0.16, 95% CI -0.26 to -0.06; I2 = 0%). No serious BV-related AEs, including anaphylaxis, were reported. BV pharmacopuncture may improve pain and treatment response in RA without increasing the risk of AEs. However, these findings are supported by low certainty of evidence, and the effect on disease activity remains uncertain. Further high-quality RCTs with standardized treatment protocols and validated outcome measures are warranted to establish its clinical efficacy and safety. https://www.crd.york.ac.uk/PROSPERO/view/CRD42021238058, PROSPERO CRD42021238058.
SN - 2296-858X
ER -