Putative analgesic activity of repeated oral doses of vitamin E in the treatment of rheumatoid arthritis. Results of a prospective placebo controlled double blind trial

Abstract

Objective-Vitamin E, the most potent naturally occurring lipid soluble antioxidant has been suggested to possess both anti-inflammatory and analgesic activity in humans. This double blind and randomised study used a broad spectrum of clinical and laboratory parameters to investigate whether there was any additional anti-inflammatory or analgesic effects, or both, of orally administered -tocopherol in rheumatoid arthritis patients who were already receiving antirheumatic drugs. Methods-Forty two patients were enrolled and treated with -tocopherol (n=20) at a dose of 600 mg twice a day (2 × 2 capsules) or with placebo (n=22) for 12 weeks. The following parameters were measured: (1) Three clinical indices of inflammation-the Ritchie articular index, the duration of morning stiVness, and the number of swollen joints; (2) three measures of pain-pain in the morning, pain in the evening, and pain after chosen activity; (3) haematological and biochemical measures of inflammatory activity; (4) assays for the oxidative modification of proteins and lipids. Results-All laboratory measures of inflammatory activity and oxidative modification were unchanged. Furthermore, the clinical indices of inflammation were not influenced by the treatment. However, the pain parameters were significantly decreased after vitamin E treatment when compared with placebo. Conclusion-The results provide preliminary evidence that vitamin E may exert a small but significant analgesic activity independent of a peripheral antiinflammatory eVect, but which complements standard anti-inflammatory treatment.

Intake of antioxidants in patients with rheumatoid arthritis

“…Edmonds et al 21 have shown that vitamin E supplementation (600 mg/day) improves the clinical symptoms of the disease, through a possible mechanism of reduced formation of prostaglandins, molecules produced during inflammatory processes.…”

Nutrient supplementation with polyunsaturated fatty acids and micronutrients in rheumatoid arthritis: clinical and biochemical effects

“…With respect to micronutrients, little is known about the doses needed to induce immunomodulation (Rosenstein & Caldwell, 1999). Studies with single antioxidants failed to demonstrate a significant clinical effect of high doses of selenium, or vitamin E in RA patients (Tarp et al, 1985;Edmonds et al, 1997;Peretz et al, 2001). Although our study was primarily designed to investigate the potential add-on effects of PUFA and micronutrient supplementation on symptoms and disease activity, other beneficial clinical effects cannot be excluded, cardioprotective in particular.…”

“…Nevertheless, clinical trials with antioxidants in RA patients have been disappointing. A randomized double-blind comparison of high-dose vitamin E (1200 mg daily), the most powerful naturally occurring lipid-soluble antioxidant, did not show any anti-inflammatory effect as compared to placebo (Edmonds et al, 1997). Two placebo-controlled trials with selenium-enriched yeast (200 and 156 mg/day) did not result in detectable clinical benefit (Tarp et al, 1985;Peretz et al, 2001).…”

Efficacy of vitamin E in knee osteoarthritis management of North Indian geriatric population

“…Considerable attention has been devoted to the potential use of α-tocopherol, a potent chain breaking antioxidant, in the prevention of age-related complications [Yu et al 1998]. Although in previous clinical studies vitamin E has been found to be effective in the symptomatic treatment of arthritis and osteoporosis [Edmonds et al 1997;Chavan et al 2007], controversial reports on the inefficacy of vitamin E in the management of OA have been documented [Brand et al 2001]. The mechanism underlying its effect in ameliorating the enzyme activities, levels of MDA (i.e.…”