Clinical trials of integrative medicine for rheumatoid arthritis: Issues and recommendations

Zhang, Chi; Jiang, Miao; He, Xiao juan; Lü, Aiping

doi:10.1007/s11655-015-2041-5

Cited by 9 publications

(4 citation statements)

References 17 publications

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“…In this review, authors have concluded that TW extracts are a sort of "herbal DMARD" with a similar efficacy to synthetic DMARDs in RA treatment and that well-designed confirmatory randomized controlled trials should be done (14). Recently, Zhang and co-workers have shown in a multicenter, open-label, randomized controlled trial that combined therapy of methotrexate (MTX) and TW was more effective than MTX monotherapy in the treatment of active RA patients (15, 16). In this study, about 52.7% of the 207 patients experienced adverse events, which were seen in 46.4, 62.3, and 49.3% of patients receiving TW (20 mg, three times per day), MTX (12.5 mg/week), and TW + MTX, respectively ( p = 0.136).…”

Section: Clinical Experience With the Use Of Twmentioning

confidence: 99%

Celastrol: A Spectrum of Treatment Opportunities in Chronic Diseases

2017

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The identification of new bioactive compounds derived from medicinal plants with significant therapeutic properties has attracted considerable interest in recent years. Such is the case of the Tripterygium wilfordii (TW), an herb used in Chinese medicine. Clinical trials performed so far using its root extracts have shown impressive therapeutic properties but also revealed substantial gastrointestinal side effects. The most promising bioactive compound obtained from TW is celastrol. During the last decade, an increasing number of studies were published highlighting the medicinal usefulness of celastrol in diverse clinical areas. Here we systematically review the mechanism of action and the therapeutic properties of celastrol in inflammatory diseases, namely, rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel diseases, osteoarthritis and allergy, as well as in cancer, neurodegenerative disorders and other diseases, such as diabetes, obesity, atherosclerosis, and hearing loss. We will also focus in the toxicological profile and limitations of celastrol formulation, namely, solubility, bioavailability, and dosage issues that still limit its further clinical application and usefulness.

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Section: Clinical Experience With the Use Of Twmentioning

confidence: 99%

Celastrol: A Spectrum of Treatment Opportunities in Chronic Diseases

2017

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“…Lu, AP broadened the understanding of various factors that can affect the sensitivity of herbal medical interventions by studying the combined effect of different herbs and their interaction with each other. [ 19 ] South Korea has been conducting research on certain pharmacological ingredients extracted from herbs. [ 20 ] This information about the authors, organizations, and countries will contribute to cooperation and communication between researchers across the world.…”

Section: Discussionmentioning

confidence: 99%

Bibliometric analysis of research relating to the use of herbal medicine for rheumatoid arthritis between 1991 to 2021

Kang

Kim

et al. 2022

Medicine

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Background: Rheumatoid arthritis (RA) is an inflammatory autoimmune disease, which is well known for its poor symptoms, and the incidence is increasing worldwide. Although conventional medicines are practiced initially, patients often move or accompany to complementary and alternative medicines for better outcomes. Herbal medications, one of traditional medicinal approach, are widely used in clinical conditions. However, no research has broadly reviewed the current research trends regarding the scope of herbal medicines in RA. The aim of this study was to conduct a bibliometric analysis of applications of herbal medicine for RA from 1991 to the present Methods: We retrieved literature on herbal medicine for RA from the Web of Science database from 1991 to 2021. The VOSviewer program was used to analyze keywords, authors, countries, and organizations through visual knowledge mapping to assess the research hotspots and trends. Results: A total of 516 articles were included in the analysis, which showed an increasing trend in the number of publications over time. Four clusters were identified from the keyword analysis: complementary and alternative medicine cluster, mechanism of the pain cluster, control for the pain cluster, and recent research trend cluster. People’s Republic of China published 250 articles, which was the greatest number of publications, followed by the United States of America (82 articles) and South Korea (52 articles). Furthermore, Moudgil, KD of the University of Maryland published 15 articles about the mechanism of herbal medicine on autoimmune arthritis and their interaction with various drugs. Lu, AP of the Hong Kong Baptist University published 14 articles about herbal medicine interactions. On an institutional level, the China Academy of Chinese Medical Science published 33 articles, followed by the Hong Kong Baptist University and the University of Maryland with 27 and 20 articles, respectively. Clusters of organizations from the People’s Republic of China and the United States of America revealed higher average citations for earlier average publication years. Conclusions: This bibliometric study identified trends in herbal medicine for RA from 1991 to 2021, which may guide the hot topics and future directions in this research field.

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“…In general, the most frequent side effects reported in these clinical trials were gastrointestinal disturbances. ( 2 , 3 , 57 – 60 ) More recently, a study has shown that a combination therapy of TW extracts and methotrexate (MTX) is more effective than MTX alone ( 4 , 61 ). This can be a strategy to lower the dose of TW extracts or of celastrol, thus limiting the side effects.…”

Section: Discussionmentioning

confidence: 99%

Celastrol Efficacy by Oral Administration in the Adjuvant-Induced Arthritis Model

et al. 2020

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Background: We previously demonstrated that celastrol has significant anti-inflammatory and bone protective effects when administered via the intraperitoneal route. For further preclinical evaluation, an effective oral administration of celastrol is crucial. Here we aimed to study the therapeutic dose range for its oral administration. Methods: Celastrol (1-25 µg/g/day, N = 5/group) was administrated orally to female adjuvant-induced arthritis (AIA) rats after 8 days of disease induction for a period of 14 days. A group of healthy (N = 8) and arthritic (N = 15) gender-and age-matched Wistar rats was used as controls. During the treatment period, the inflammatory score, ankle perimeter, and body weight were measured. At the end of the treatment, the animals were sacrificed, blood was collected for clinical pathology, necropsy was performed with collection of internal organs for histopathological analysis, and paw samples were used for disease scoring. Results: Doses higher than 2.5 µg/g/day of celastrol reduced the inflammatory score and ankle swelling, preserved joint structure, halted bone destruction, and diminished the number of synovial CD68+ macrophages. Bone resorption and turnover were also reduced at 5 and 7.5 µg/g/day doses. However, the dose of 7.5 µg/g/day was associated with thymic and liver lesions, and higher doses showed severe toxicity. Conclusion: Oral administration of celastrol above 2.5 µg/g/day ameliorates arthritis. This data supports and gives relevant information for the development of a preclinical test of celastrol in the setting of a chronic model of arthritis since rheumatoid arthritis is a long-term disease.

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Clinical trials of integrative medicine for rheumatoid arthritis: Issues and recommendations

Cited by 9 publications

References 17 publications

Celastrol: A Spectrum of Treatment Opportunities in Chronic Diseases

Celastrol: A Spectrum of Treatment Opportunities in Chronic Diseases

Bibliometric analysis of research relating to the use of herbal medicine for rheumatoid arthritis between 1991 to 2021

Celastrol Efficacy by Oral Administration in the Adjuvant-Induced Arthritis Model

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