l

The content of this website is intended for healthcare professionals only

Chinese herbal remedy works as well as methotrexate for RA

Triptergyium wilfordii Hook F used to relieve joint pain and inflammation in traditional Chinese medicine

Caroline White

Tuesday, 15 April 2014

A traditional Chinese herbal remedy used to relieve joint pain and inflammation works as well as methotrexate, a standard drug treatment frequently prescribed to control the symptoms of active rheumatoid arthritis, reveals research* published online in the Annals of the Rheumatic Diseases.

And combining the herbal remedy with methotrexate—the disease modifying drug (DMARD) most commonly used to treat rheumatoid arthritis—was more effective than using methotrexate alone, the findings showed.

Triptergium wilfordii Hook F, or TwHF for short, is used in traditional Chinese medicine to treat joint pain, swelling, and inflammation, and is already approved for the treatment of rheumatoid arthritis in China.

The research team randomly assigned 207 patients with active rheumatoid arthritis to one of three treatment groups: methotrexate 12.5 mg once a week; or TwHF 20 mg three times a day; or a combination of the two, over a period of 24 weeks.

The researchers wanted to find out which of these approaches would sufficiently alleviate symptoms to reach an ACR50 response— a measure defined by the American College of Rheumatology.

This indicates a 50% improvement in the number of tender or swollen joints and other criteria including pain, disability, and the doctor’s assessment of disease severity.

Most (174; 84%) of the participants completed all 24 weeks of the trial. The proportion achieving ACR 50 was almost 46.5% in those treated with methotrexate alone; 55% in those treated with TwHF alone; and just under 77% in those treated with both.

Similar clinically significant patterns of improvement in disease activity and remission rates also occurred.

There was little difference between the frequency or type of side effects experienced among the different treatment groups, although the number of women who developed irregular periods was slightly higher in those treated with TwHF.

More than 300 compounds have been identified in TwHF, including diterpenoids, which, experimental research suggests, can suppress genes controlling inflammation and dampen down the immune response, the authors point out.

And an extract of the root has recently been investigated for its potential to treat autoimmune diseases and some cancers, say the researchers.

They caution that 24 weeks is too short a time to evaluate disease progression, and that the dose of methotrexate used in the trial is lower than that typically given to patients in the West.

But they suggest that TwHF could be a promising approach to the treatment of active rheumatoid arthritis, particularly as not all patients respond to DMARDs, and because these drugs are expensive.


* Qian-wen Lv, Wen Zhang, Qun Shi, et al. Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis (TRIFRA): a randomised, controlled clinical trial. Ann Rheum Dis. Published Online First 14 April 2014. doi:10.1136/annrheumdis-2013-204807

Registered in England and Wales. Reg No. 2530185. c/o Wilmington plc, 5th Floor, 10 Whitechapel High Street, London E1 8QS. Reg No. 30158470