Effects of melatonin supplementation on disease activity, oxidative stress, inflammatory, and metabolic parameters in patients with rheumatoid arthritis: a randomized double-blind placebo-controlled trial

Esalatmanesh, Kamal; Loghman, Amirhossein; Esalatmanesh, Roozbeh; Soleimani, Zahra; Khabbazi, Alireza; Mahdavi, Aida Malek; Mousavi, Seyed Gholam Abbas

doi:10.1007/s10067-021-05670-2

Cited by 14 publications

(14 citation statements)

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“…Serum TAC level did not change considerably in the melatonin group compared with baseline and placebo group. Our results were consistent with previous reports that supported the affirmative effects of melatonin supplementation in reducing oxidative stress markers and improving antioxidant status in various conditions 23–32,49 . According to Mesri Alamdari et al 23 , melatonin consumption (6 mg/day for 40 days) decreased serum MDA levels significantly and increased serum TAC level slightly in obese women.…”

Section: Discussionsupporting

confidence: 93%

“…Melatonin stimulates the antioxidant enzymes function and elevates the efficiency of other antioxidants 20 . Based on our study, disease activity did not change significantly in the melatonin group compared with baseline and placebo group which was consistent with Esalatmanesh et al 49 and Forrest et al 50 who indicated no significant improvement in clinical symptoms and disease severity of RA patients after melatonin treatment. Furthermore, Afkhamizadeh et al 53 reported no significant correlation between RA disease activity or other disease characteristics and serum melatonin levels.…”

Section: Discussionsupporting

confidence: 89%

“…Furthermore, Panah et al 32 indicated that 3 mg/day oral melatonin consumption for 25 days in transplant patients caused a considerable reduction in serum MDA compared with placebo. In addition, Esalatmanesh et al 49 demonstrated that 6 mg/day melatonin supplementation in rheumatoid arthritis (RA) patients for 12 weeks significantly decreased serum MDA compared with placebo, whilst it did not change serum TAC significantly compared with placebo. However, another study conducted in RA patients indicated that 10 mg/day melatonin supplementation for six months did not cause significant decrease in lipid peroxidation products compared with the placebo 50 which was in contrast with our research.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, current study is the first randomised double- Our results were consistent with previous reports that supported the affirmative effects of melatonin supplementation in reducing oxidative stress markers and improving antioxidant status in various conditions. [23][24][25][26][27][28][29][30][31][32]49 According to Mesri Alamdari et al 23 , melatonin consumption (6 mg/day for 40 days) decreased serum MDA levels significantly and increased serum TAC level slightly in obese women. Another study in obese patients indicated that melatonin supplementation (10 mg/day for 30 days) reduced MDA concentrations, whereas glutathione peroxidase (GPx) activity increased significantly.…”

Section: Ta B L E 2 Biochemical and Clinical Factors Of Subjects At Baseline And After 12 Weeksmentioning

confidence: 99%

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Effects of melatonin supplementation on serum oxidative stress markers and disease activity in systemic lupus erythematosus patients: A randomised, double‐blind, placebo‐controlled trial

et al. 2021

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Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease identified by the presence of autoantibodies. 1 SLE is marked by phases of remission and exacerbation and has different symptoms such as arthritis, skin lesions, nephritis, serositis, and nervous system symptoms. 1 SLE mainly affects women of child-bearing age. 1 SLE has multifactorial etiology including genetic, hormonal, and environmental factors that leads to immune dysfunction. 1 Recently, it has been indicated that free radical damage and oxidative stress has a remarkable function in SLE pathogenesis. 2 Oxidative stress causes T helper 17/regulatory T (Th17/Treg) cells imbalance in SLE subjects. Under normal situation, Th17 and Treg cells are in balance, whilst oxidative stress generated in SLE can stimulate and increase proinflammatory Th17 cells and suppresses anti-inflammatory Treg cells, thereby exacerbating autoimmune injury. 3 Moreover, oxidative stress can lead to abnormal activation of apoptosis and delay in the apoptotic bodies clearance. This delay in clearance of apoptotic cells

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Ta B L E 2 Biochemical and Clinical Factors Of Subjects At Baseline And After 12 Weeksmentioning

confidence: 99%

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Effects of melatonin supplementation on serum oxidative stress markers and disease activity in systemic lupus erythematosus patients: A randomised, double‐blind, placebo‐controlled trial

et al. 2021

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“…They found no association between the serum levels of melatonin with DAS and even other factors including; disease duration, age, gender, medications, or sampling season in RA patients. Similarly, Esalatmanesh et al [35] showed that 12 weeks of melatonin supplementation (6 mg/day) in patients with RA, although significantly reduced malondialdehyde (as a lipid peroxidation marker) and low-density lipoprotein cholesterol (LDL-C) levels in plasma, but had no effect on DAS. Therefore, it seems that different doses of melatonin in different treatment durations maybe is one of the reasons of different consequences.…”

Section: Discussionmentioning

confidence: 97%

Effects of Melatonin on Sleep Quality and Disease Activity in Patients With Rheumatoid Arthritis

et al. 2022

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Background and Objective In rheumatoid arthritis (RA) patients sleep disturbance is one of serious and prevalent problems. Considering the known effects of melatonin on sleep quality and inflammation, this study aimed to investigate melatonin supplementation effect on quality of sleep and disease activity in patients with RA.Methods In this randomized, placebo-controlled trial (double-blind), 64 RA patients were selected and divided into experimental and placebo groups randomly; experimental group received 3 mg/d of melatonin and another group consumed placebo for 60 days. Before and after the investigation, assessment of the quality of sleep determined using the Pittsburgh Sleep Quality Index (PSQI). Disease Activity Score-28 (DAS28) and the Visual Analogue Scale (VAS) questionnaires were used for evaluation of disease activity and pain intensity, respectively.Results Melatonin significantly reduced PSQI, DAS28 and VAS scores, when values compared with baseline. In contrast to placebo group, good sleep quality within the melatonin group increased significantly compared to baseline and this improvement in sleep quality was significant when compared between groups. The scores of DAS28 and pain VAS at the end of trial were significantly reduced compared to the baseline in both groups. However, reduction in the DAS28 and VAS scores of the melatonin group were stronger than reductions in the placebo receiving group.Conclusions This study results revealed that melatonin was safe and effective in improving sleep quality and reducing DAS28 and pain VAS scores in RA patients.

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Long‐Term Safety Profiles of Macrolides and Tetracyclines: A Systematic Review and Meta‐Analysis

Waitayangkoon,

Moon,

Tirupur Ponnusamy

et al. 2023

The Journal of Clinical Pharma

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Macrolides and tetracyclines are antibiotics that have a range of anti‐inflammatory properties beyond their microbial capabilities. Although these antibiotcs have been in widespread use, the long‐term safety profiles are limited. We performed a systematic review and meta‐analysis of randomized clinical trials (RCTs) that compared macrolides or tetracyclines with placeboes to provide long‐term safety information. We searched Medline and EMBASE from inception to October 2022 and identified studies that reported study‐drug‐related death, serious adverse events (SAEs), or withdrawal rates, and common adverse effects of each drug. Relative risk (RR) and number needed to harm (NNH) were calculated. Of the 52 RCTs included, there are 3,151 participants on doxycycline, 2,519 participants on minocycline, 3,049 participants on azithromycin, 763 participants on clarithromycin, 262 participants on erythromycin, and 100 participants on roxithromycin. There was no death related to any study drugs and rates of SAE were not significantly different from placebo in any drug. Overall withdrawal rates were slightly higher than placebo in doxycycline (RR, 1.30; 95% CI, 1.12‐1.52) and minocycline (RR, 1.29; 95% CI, 1.15‐1.46). Withdrawal rates due to adverse events were higher in doxycycline (RR, 2.82; 95% CI, 1.88‐4.22), minocycline (RR, 1.48; 95% CI, 1.09‐1.98), and azithromycin (RR, 1.53; 95% CI, 1.13‐2.08). Gastrointestinal (GI) disturbances are the most common tolerable adverse effects for every drug. Photosensitivity and rash are the second most common for doxycycline and minocycline. We found no evidence that long‐term use up to 2 years of macrolides or tetracyclines was associated with increased risk of SAEs.This article is protected by copyright. All rights reserved

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Effects of melatonin supplementation on disease activity, oxidative stress, inflammatory, and metabolic parameters in patients with rheumatoid arthritis: a randomized double-blind placebo-controlled trial

Cited by 14 publications

References 35 publications

Effects of melatonin supplementation on serum oxidative stress markers and disease activity in systemic lupus erythematosus patients: A randomised, double‐blind, placebo‐controlled trial

Effects of melatonin supplementation on serum oxidative stress markers and disease activity in systemic lupus erythematosus patients: A randomised, double‐blind, placebo‐controlled trial

Effects of Melatonin on Sleep Quality and Disease Activity in Patients With Rheumatoid Arthritis

Long‐Term Safety Profiles of Macrolides and Tetracyclines: A Systematic Review and Meta‐Analysis

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