A traditional Chinese remedy may work as well as a widely used drug to relieve the symptoms of rheumatoid arthritis. And using both treatments together may work better than using either on its own.
What do we know already?
Rheumatoid arthritis is a long-term condition that causes joints to become painful, stiff, and swollen. It happens when the immune system mistakenly attacks the linings of the joints, making them inflamed.
The main treatments for rheumatoid arthritis are medicines called disease-modifying anti-rheumatic drugs, or DMARDs for short. The most common is methotrexate.
Although DMARDs can improve the symptoms of rheumatoid arthritis, they don’t work for everyone. They can also cause side effects in some people, including loss of appetite and blisters or acne.
Some previous research had suggested that a traditional Chinese herbal remedy may provide an effective alternative. It is made from a plant called Tripterygium wilfordii Hook F (TwHF for short). Recent studies have found that TwHF can improve the symptoms of rheumatoid arthritis more than a dummy treatment (a placebo) and a DMARD called sulfasalazine. However, these studies have not compared TwHF with methotrexate.
How was the new study done?
The new study included 207 people in China who had rheumatoid arthritis. Most had never taken a DMARD before. The researchers randomly assigned them to take methotrexate, TwHF, or both treatments for 24 weeks. If the people taking either treatment alone didn’t improve much after 12 weeks, they started taking both treatments.
The researchers used several questionnaires and scales to measure people’s symptoms throughout the study. The main result they looked at is called the ACR50 response. This means that a person has at least a 50 percent improvement in their number of tender or swollen joints, as well as in other areas, such as being able to do more physically.
What does the new study say?
A similar number of people had an ACR50 response whether they took methotrexate or TwHF. Around 46 in every 100 people taking methotrexate had this level of improvement compared with 55 in every 100 people taking TwHF. However, taking both treatments worked even better, with nearly 77 in every 100 people having an ACR50 response.
Side effects were similar in all three groups of people, with the most common being problems with digestion, such as nausea and loss of appetite. The side effects were usually mild. Fifteen women stopped having regular periods during the study. This was slightly more common among those taking TwHF.
How reliable is the research?
This was a type of study called a randomised controlled trial, which is the best type of study for comparing treatments. It was also fairly large and most people completed the study. This makes its findings more reliable.
However, the researchers weren’t able to hide which treatments people were taking. This means that people’s expectations might have affected their response to the treatments, such as how they rated their symptoms.
Also, bear in mind that the study lasted only 24 weeks, so we don’t know how this treatment might affect people in the longer term.
The researchers also note that the dose of methotrexate used in the study – 12.5 milligrams per week – is lower than the dose often used in Western countries. So it’s possible that the Chinese remedy might not work as well as a higher dose of methotrexate.
What does this mean for me?
If you have rheumatoid arthritis, you may find these results quite encouraging, particularly if you are interested in treatments beyond the standard DMARDs. However, the research on TwHF is at an early stage and this treatment is still considered experimental in Western countries. The plant used in this treatment – sometimes called léi gōng téng – can also be highly toxic. Because of safety concerns, the Medicines and Healthcare products Regulatory Agency (MHRA) currently recommends that people in the UK don’t use Chinese medicines containing this herbal ingredient.
If you have questions about TwHF, or about any treatment for rheumatoid arthritis, speak with your doctor.
Source: Best Health
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