Abstract

Long term effectiveness of RA- 1 as a monotherapy and in combination with complaint modifyinganti-rheumatic medicines in the treatment of rheumatoid arthritis

Author(s): D. Schiphof

Background Data on long term use of Ayurveda medicines is meagre. They may prove useful if combined with ultramodern drug in certain clinical situations (integrative drug). We present the results of a long term experimental study of RA- 1(Ayurveda medicine) used in the treatment of rheumatoid arthritis (RA). The ideal was to study safety of long term use of RA- 1 for treatment of rheumatoid arthritis (RA).

Material and Method: On completion of a 16 week randomized controlled study, 165 subscribing levy cases were enrolled into a three time open marker phase (OLP) study. Cases were characteristic with patient active complaint and naïve for complaint modifyinganti-rheumatic medicines (DMARD). 57 cases were on fixed low cure prednisone. Cases were examined every 10 – 14 weeks in a routine rheumatology practice using standard care morals. They continued RA- 1(Arthrex ™, 2 tablets doubly daily) throughout the study period and were generally advised to lead a healthy life style. Grounded on clinical judgment, rheumatologist added DMARD and/ or steroids (modified if formerly in use) to cases with shy response; chloroquine and/ or methotrexate generally used. Treatment response was assessed using American College of Rheumatology( ACR) efficacy measures and ACR 20 enhancement indicator standard update statistical software( SAS and SPSS) were used; significant at p<0.05.

Results: 158, 130 and 122 cases independently completed evaluations at 1, 2 and 3 time primary end point. The ACR 20 response (range 34 – 40) remained stable over three times (p = 0.33). Cases bettered optimum for several measures by one time (p<0.05) and this was sustained. The use of steroids varied from 42 to 49 cases at monthly end points (mean diurnal cure 5 mg prednisone); similarly the use of DMARD varied from 20 to 34 cases. 40 cases on RA- 1 didn't bear DMARD/ steroids for control of complaint. 77 cases reported adverse events, albeit mild and substantially gut related and not causing pull-out. Several study limitations (especially tone- selection) were reduced by the high case retention and thickness in medicine use [1].

Conclusion: RA- 1 is safe and effective in the long term operation of characteristic active habitual RA. DMARDs and/ or steroids can be used judiciously along with RA- 1 to treat delicate complaint/ flares. Farther studies are needed to estimate RA- 1 in early RA. This paves way for exploration and operation of integrative remedial approach in clinical drug.