Acupuncture in the Treatment of Systemic Lupus Erythematosus: Clinical Evidence and Perspectives

Introduction: Systemic lupus erythematosus (SLE) is a complex chronic autoimmune disease characterized by heterogeneous clinical manifestations and the potential for irreversible organ damage. Despite advances in pharmacological treatment, many patients continue to experience persistent symptoms, adverse effects, and reduced quality of life. Acupuncture has been proposed as a complementary therapy aimed at pain relief, immune modulation, and functional improvement. Objective: To critically review the efficacy and safety of acupuncture in the management of SLE, integrating recent clinical evidence, including randomized controlled trials, systematic reviews, case reports, and observational studies. Methods: A systematized narrative review was conducted using international databases, without language restrictions, up to September 2025. Randomized controlled trials, systematic reviews, meta-analyses, and clinical case reports were included. Results: Seven clinical trials, one meta-analysis including 514 patients, and multiple case reports were identified. The studies demonstrated significant improvements in pain, fatigue, quality of life, and laboratory markers such as anti-dsDNA and complement levels, particularly when acupuncture was combined with conventional therapy. The meta-analysis also showed a reduction in adverse events compared to pharmacological treatment alone. However, heterogeneity in acupuncture protocols and methodological limitations reduce the strength of the evidence. Conclusion: Acupuncture represents a promising adjunctive intervention in the treatment of SLE; however, robust multicenter studies are needed to confirm its efficacy and establish standardized protocols.