The Role of Complementary and Alternative Medicine (CAM) in Rheumatology — It’s Time for Integrative Medicine

Michalsen, Andreas

doi:10.3899/jrheum.130107

Cited by 15 publications

(17 citation statements)

References 21 publications

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“…People with chronic rheumatic diseases or advanced-stage cancers who did not achieve the expected level of benefit from modern medical treatment represent a large portion of patients who express interest in pursuing alternative medical treatments as a complementary or alternative approach to evidence-based therapies [7]. However, both of the patients described herein represent the population of people with diseases who chose to forego evidence-based medical treatments in favor of a traditional herbal medicine approach, presenting for care at a modern medical facility only after substantially bothersome physical effects manifested from the alternative method.…”

Section: Discussionmentioning

confidence: 99%

Alternative medicine for management of breast masses: More harm than good

Çan

2014

Am J Case Rep

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Case seriesPatient: —Final Diagnosis: Breast cancerSymptoms: —Medication: —Clinical Procedure: —Specialty: —Objective:Diagnostic/therapeutic accidentsBackground:Several well-established, evidence-based treatment modalities are currently available and widely applied to breast cancer patients, but it is known that some of the cancer patients use traditional/alternative medicine other than their treatments.Case Report:Herein, we report the cases of 2 middle-aged women (45 and 50 years old) with malignant breast masses who experienced serious complications in response to self-prescribed use of alternative medicine practices to treat their condition in lieu of evidence-based medical treatment. Specifically, the use and/or inappropriate application of alternative medical approaches promoted the progression of malignant fungating lesions in the breast for these 2 patients. The first patient sought medical assistance upon development of a fungating lesion 7∼8 cm in diameter and involving 1/3 of the breast, with a palpable mass of 5×6 cm immediately beneath the wound. The second patient sought medical assistance upon development of a wide, bleeding, ulcerous area with patchy necrotic tissue that comprised 2/3 of the breast and had a 10×6 cm palpable mass under the affected area. Use of some non-evidence-based medical treatments as complementary to evidence-based medical treatments may benefit the patient on an emotional level; however, this strategy should be used with caution, as the non-evidence-based therapies may cause physical harm or even counteract the evidence-based treatment.Conclusions:A malignant, fungating wound is a serious complication of advanced breast cancer. It is critical that the public is informed about the potential problems of self-treating wounds such as breast ulcers and masses. Additionally, campaigns are needed to increase awareness of the risks and life-threatening potential of using non-evidence-based medical therapies exclusively.

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Section: Discussionmentioning

confidence: 99%

Alternative medicine for management of breast masses: More harm than good

Çan

2014

Am J Case Rep

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“…CAM is gaining overall popularity [12,20] and a number of studies show that CAM can be used to ameliorate pain, alleviate gastrointestinal conditions, help with depression, reduce stress, improve sleep and promote general health in a variety of ages and across a number of disease populations [20][21][22]. One specific example is a small study with rheumatoid arthritis (RA) patients who used a structured bi-weekly yoga program with positive outcomes by lowering disease activity scores, decreasing fatigue and reducing medication use [23].…”

Section: Discussionmentioning

confidence: 99%

What Everybody is Doing but No One is Talking About: Use of Complementary and Alternative Medicine in the ANCA Associated Vasculitis Population

Berg

Burkart

et al. 2014

J. Autoimmune Dis. Rheumatol.

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The use and impact of complementary and alternative medicine (CAM) for anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) has not been reported. AAV patients seeking care at our center inquired about CAM, prompting a formal study. Study objectives were to discern how many AAV patients used CAM and its perceived helpfulness in disease management.Methods-AAV patients completed a CAM questionnaire between July 2011 and May 2012. Patients were 18 years or older and had biopsy proven and/or clinical evidence of AAV. Medical record abstraction supplemented data. Classification detailed CAM type including "Mind" or "Mind-Body". Perceived helpfulness of CAM was assessed as "very", "somewhat" or "not at all/ don't know".Results-A total of 107 patients participated and were a mean age of 53 (range: 18-85), 62% female; 48% proteinase 3 (PR3)-ANCA, 44% myeloperoxidase (MPO)-ANCA and 8% ANCAnegative. Top organs involved included kidney (87%), joints (55%), lung (53%) and upper respiratory (53%).At least one type of CAM treatment or self-help practice was reported by 81% of study participants, with the most frequent being prayer (64%), exercise (27%) and massage therapy (19%). Mind-based practices were used by 28% (excluding prayer) and Mind-Body practices by 14%. Most practices were used to improve wellbeing, and Mind and Mind-Body were deemed very helpful by 83% and 87% respectively. Only 24% of study participants discussed CAM with their physician.

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“…However, these drugs are associated with a potential risk of infection, fatigue, and liver damage (Salliot and van der Heijde, 2009). To avoid the side effects and debilitation associated with western medical treatment, the patients resorted to using traditional herbal remedies (Efthimiou and Kukar, 2010;Michalsen, 2013).…”

Section: Introductionmentioning

confidence: 99%

Adjunctive Chinese Herbal Products Therapy Reduces the Risk of Ischemic Stroke Among Patients With Rheumatoid Arthritis

2020

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We performed a retrospective cohort study to investigate the association between the risk of ischemic stroke (IS) and the use of Chinese herbal products (CHP) in combination with western medicine (WM) among patients with rheumatoid arthritis (RA). The data were sourced from the registry for beneficiaries, inpatient and ambulatory care claims, and Registry for Catastrophic Illness from the National Health Insurance Research Database (NHIRD) in Taiwan between 1997 and 2011. Patients, who were newly diagnosed with RA between 1997 and 2010, were classified as the CHP group or non-CHP group depending on the presence of absence the adjunctive use of CHP following a diagnosis of RA. A total of 4,148 RA patients were in both the CHP and non-CHP groups after 1:1 matching. Patients in the CHP group had a significantly lower risk of IS compared to patients in the non-CHP group (adjusted hazard ratio [aHR], 0.67; 95% confidence interval [CI], 0.52-0.86). In the CHP group, patients who used CHP for more than 30 days had a lower risk of IS than their counterparts (aHR: 0.61, 95% CI: 0.40-0.91). Gui-Zhi-Shao-Yao-Zhi-Mu-Tang, Shu-Jin-Huo-Xie-Tang, and Du-Huo-Ji-Sheng-Tang might be associated with a lower risk of IS. Finally, the use of CHP in combination with WM was associated with a decreased risk of IS in patients with RA, especially among those who had used CHP for more than 30 days. A further randomized control trial is required to clarify the casual relationship between these results.

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The Role of Complementary and Alternative Medicine (CAM) in Rheumatology — It’s Time for Integrative Medicine

Cited by 15 publications

References 21 publications

Alternative medicine for management of breast masses: More harm than good

Alternative medicine for management of breast masses: More harm than good

What Everybody is Doing but No One is Talking About: Use of Complementary and Alternative Medicine in the ANCA Associated Vasculitis Population

Adjunctive Chinese Herbal Products Therapy Reduces the Risk of Ischemic Stroke Among Patients With Rheumatoid Arthritis

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