Ayurvedic medicine for rheumatoid arthritis: A systematic review

doi:10.1016/j.semarthrit.2004.11.005

Seminars in Arthritis and Rheumatism

Volume 34, Issue 5, April 2005, Pages 705-713

https://doi.org/10.1016/j.semarthrit.2004.11.005 Get rights and content

Objective

To systematically review all randomized controlled trials (RCTs) on the effectiveness of Ayurvedic medicine for rheumatoid arthritis (RA).

Methods

Computerized literature searches for all RCTs of Ayurvedic medicine for RA in the following databases: Medline (March 1969 to March 2003), Embase (February 1985 to February 2003), AMED (March 1980 to March 2003), Cochrane Controlled Trial Register (October 1997 to March 2003), and the abstract service of Central Council for Research in Ayurveda and Siddha (CCRAS; 1976 to March 2003). Hand searches were performed in 1 Sri Lankan and 3 Indian journals and the authors’ personal files. Key data of included studies were extracted and reviewed. The methodological quality of all studies was evaluated with the Jadad scale.

Results

Seven studies met our inclusion criteria. Trials tested either Ayurvedic medicine against placebo or other Ayurvedic medicines. In general, patient and physician global assessments on the severity of pain, and morning stiffness were used as endpoints. Of 3 placebo-controlled RCTs, 1 high-quality trial did not show benefit of the active treatment against placebo, while another incompletely reported study indicated beneficial effects of an Ayurvedic medicine. A further incompletely reported study showed no significant difference. The remaining 4 trials were difficult to interpret because they tested an Ayurvedic medicine against other Ayurvedic medicines whose effects were not proven.

Conclusion

There is a paucity of RCTs of Ayurvedic medicines for RA. The existing RCTs fail to show convincingly that such treatments are effective therapeutic options for RA.

Section snippets

Inclusion and exclusion criteria

We included all studies that met all of the following criteria: (1) randomized study in which any form of Ayurvedic medicine, ie, medicinal preparation administered orally or topically, was tested; and (2) the study was performed on RA patients. Studies solely on osteoarthritis (OA) and those testing therapies other than herbal medicines were excluded. RCTs of single herbs not following the principles of Ayurvedic medicine were excluded.

Search strategy

Systematic literature searches were conducted to identify

Results

A total of 33 articles were initially identified. Of these, 7 studies met the inclusion criteria (11, 12, 13, 14, 15, 16, 17). The other 26 studies were excluded because 2 of them were nonrandomized, controlled trials (18, 19); 2 were comparative observational clinical trials (20, 21); 21 were uncontrolled observational clinical trials (22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42); and 1 tested the effectiveness of nonherbal therapy, that is, burning (43) (

Discussion

There is a paucity of RCTs investigating the efficacy of Ayurvedic medicines for RA. Overall, the data do not convincingly demonstrate the value of Ayurvedic medicines for this condition. This is inconsistent with the current Ayurvedic practice (45) and the experience of 2 researchers (A.P.G. Amarasinghe, Manjari Dwvedi) who are Ayurvedic physicians and who believe Ayurvedic medicine is a useful approach in the treatment of RA. Of 7 RCTs, only the 3 placebo-controlled studies address the

Acknowledgments

The authors acknowledge the contributions of Dr A.P.G. Amarasinghe in planning the study and extracting the data, and Dr Manjari Dwvedi of the Department of Prasudi Tantre, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, India for the data collection. Jongbae Park acknowledges the support of ILMAEK Medical Foundation for the ILMAEK Korean Research Fellowship. The majority of the study was performed at the Complementary Medicine, Peninsula Medical School, UK and the

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Citation Excerpt :
A systematic review of ayurvedic medicine for treatment of RA concluded that, “There is a paucity of RCTs of Ayurvedic medicines for RA. The existing RCTs fail to show convincingly that such treatments are effective therapeutic options for RA.”94 However, as with other many CAM therapies, especially the energy-based modalities, the issues raised by double-blind methodologies and placebo effects have not been thoroughly accounted for.

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View full text

Ayurvedic medicine for rheumatoid arthritis: A systematic review

Objective

Methods

Results

Conclusion

Section snippets

Inclusion and exclusion criteria

Search strategy

Results

Discussion

Acknowledgments

Rheum Dis Clin North Am

Med Clin North Am

Control Clin Trials

Lancet

Herbal medicines for the treatment of rheumatoid arthritisa systematic review

Rheumatology (Oxf)

Epidemiology of rheumatic diseases

Rheumatology (Oxf)

Concepts of arthritis in India’s medical traditionsAyurvedic and Unani perspectives

Soc Sci Med

Interventions for nausea and vomiting in early pregnancy

Cochrane Database Syst Rev

J Safety and anti-inflammatory activity of curcumina component of turmeric (Curcuma longa)

J Altern Complement Med

Traditional Indian systems of medicine

Ann Acad Med Singapore

Management of Amavata with certain Ayurvedic preparations

J Res Ayurveda Sidha

Randomised double blind trial of an Ayurvedic plant derived formulation for treatment of rheumatoid arthritis

J Rheumatol

Clinical evaluation of Vasti Chikitsa in the management of Amavata (Rheumatoid arthritis)

J Res Ayurveda Sidha

Efficacy of an Ayurvedic formulation in rheumatoid arthritisa double blind, placebo controlled, cross-over study

Indian J Pharmacol

Clinical study on the treatment of Amavata with compound Ayurvedic preparation

J Res Ayurveda Sidha

The study of the efficacy of Sri Lanka traditional formula on Sandigathavata

Ayurveda Sameekshawa

Is H15 (extract of Boswellia serrata, “incense”) an efficient supplementation to established drug therapy in RA? Results of a double blind pilot trial

Z Rheumatol

Garlic effectiveness in rheumatoid arthritis

Ter Arkh

Comparative efficacy of “R” compound, an indigenous formulation and aspirin in the treatment of polyarticular rheumatoid arthritis on 104 patients an open study

Antiseptic

Role of Rasayana and Dhanyamla Pinda Sveda in the management of amavata

Ayu Int Jun

Antioxidant potential of two polyherbal preparations used in Ayurveda for the treatment of rheumatoid arthritis

J Ethnopharmacol

Clinical evaluation of Ashvagandha in management of Amavata

J Res Ayurveda Sidha

Clinical trial on rheumatoid arthritis with Vyosadi Guggulu and Vachadi Kwatha

J MML Centre Rheumatic Dis—India