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Chinese Herb for Rheumatoid Arthritis

A traditional Chinese herbal remedy, dubbed the Thunder God Vine, relieves the joint pain and inflammation of rheumatoid arthritis as well as methotrexate, a standard drug treatment for the condition. The Latin name of the herb is Tripterygium wilfordii Hook F, or TwHF for short. Also, combining the herbal remedy with methotrexate was more effective than treatment with methotrexate alone, according to researchers led by Qian -wen LV at the Peking Union Medical College Hospital in Bejing. The team published their findings online in April 2014 in the Annals of the Rheumatic Diseases. TwHF 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.

A release from the publsiher reports that the 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 what is call the ACR 50 response. That is an indicator of 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. It's a measure defined by the American College of Rheumatology.

Of the participants, 84% completed the full 24 weeks of the trial. The proportion of patients 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 among the three treatment groups.

There was little difference between the frequency or type of side effects experienced in 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. An extract of the root has recently been investigated for its potential to treat automimmune diseases and some cancers, say the researchers.

The team cautions 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. Even so, 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. 

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