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Herb Shows Potential for Rheumatoid Arthritis

Study compares ancient remedy to modern drug, but not the most common, experts say,,

WEDNESDAY, Aug. 19 (HealthDay News) -- An ancient Chinese herbal remedy called "thunder god vine" helps reduce inflammation in people with rheumatoid arthritis, a new study shows.

The remedy is an extract of the medicinal plant Tripterygium wilfordii Hook F (TwHF) -- known in China as "lei gong teng" -- and has been used for centuries to treat a variety of inflammatory diseases.

The study compared reduction in joint swelling among people with rheumatoid arthritis who took either the herb or an anti-inflammatory drug.

Rheumatoid arthritis causes chronic and painful inflammation of the joints that, over time, can lead to joint damage and loss of function.

The 121 participants in the study all had at least six swollen joints. One group took 60 milligrams of TwHF root extract three times a day, and the others 1 gram of sulfasalazine (Azulfidine), a prescription anti-inflammatory drug, twice a day.

After 24 weeks, about 65 percent of those taking the herbal extract showed at least a 20 percent improvement in their joints, based on American College of Rheumatology criteria, a standard measure of the effectiveness of arthritis treatments. About 33 percent of those taking sulfasalazine improved to that degree.

A report on the findings is published Aug. 18 in Annals of Internal Medicine.

"This study is a reminder of the potential importance of supplements and herbs in the management of arthritis," said Dr. John H. Klippel, president and chief executive of the Arthritis Foundation.

Even so, the study involved a relatively small number of people, Klippel noted. Clinical trials for pharmaceuticals typically involve many more participants studied over several years, he said.

"The findings are encouraging, but [TwHF] is not likely to be recommended by rheumatologists based on the findings of this one study alone," Klippel said.

And, though sulfasalazine used to be very popular as an arthritis treatment, the drug is not used that often today in the United States, according to Dr. Stephen Lindsey, head of rheumatology at Ochsner Health Systems in Baton Rouge, La.

Methotrexate (Rheumatrex, Trexall) is the drug most often used today, he said.

"I would be optimistic that an herbal medicine would play some role in improving rheumatoid arthritis," Lindsey said. But he added that he "would be a little bit wary since the medicine they compared it to is a fairly mild, anti-rheumatoid agent and not the standard drug used in the U.S."

Other alternative remedies, he said, have proven helpful for arthritis, including fish oil, though some of them have not held up to more rigorous studies.

Participants in the new study were allowed to continue taking oral prednisone or nonsteroidal anti-inflammatory drugs, but anyone who was taking disease-modifying anti-rheumatic drugs (such as methotrexate), which slow the progression of the disease, had to stop taking them about a month before the study began.

Researchers did not see a statistically significant difference in joint damage on X-rays, Klippel said. But he said that probably was because six months wasn't long enough for noticeable changes.

The study also had a high dropout rate, with 62 percent of those taking TwHF and 41 percent of the others continuing to the end. According to the study, 17 people taking sulfasalzine and 8 taking TwHF dropped out because of adverse effects -- most often gastrointestinal symptoms, including nausea and diarrhea.

Lindsey noted that people should always remember to tell their doctor if they are taking an herbal supplement.

"Just because something is herbal doesn't mean it's going to be cheap or safe," he said.

More information

The Arthritis Foundation has more on rheumatoid arthritis

SOURCES: John H. Klippel, M.D., president and chief executive, Arthritis Foundation, Atlanta; Stephen Lindsey, M.D., head, rheumatology, Ochsner Health Systems, Baton Rouge, La.; Aug. 18, 2009, Annals of Internal Medicine

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