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18 August 2009, Vol 151, No. 4>
Summaries for Patients | 18 August 2009

The Chinese Herbal Remedy Tripterygium wilfordii Hook F in the Treatment of Rheumatoid Arthritis FREE

[+] Article and Author Information

The summary below is from the full report titled “Comparison of Tripterygium wilfordii Hook F Versus Sulfasalazine in the Treatment of Rheumatoid Arthritis: A Randomized Trial.” It is in the 18 August 2009 issue of Annals of Internal Medicine (volume 151, pages 229-240). The authors are R. Goldbach-Mansky, M. Wilson, R. Fleischmann, N. Olsen, J. Silverfield, P. Kempf, A. Kivitz, Y. Sherrer, F. Pucino, G. Csako, R. Costello, T.H. Pham, C. Snyder, D. van der Heijde, X. Tao, R. Wesley, and P.E. Lipsky.


Ann Intern Med. 2009;151(4):I-36. doi:10.7326/0003-4819-151-4-200908180-00002
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What is the problem and what is known about it so far?

In rheumatoid arthritis, inflammation causes painful, swollen joints. Rheumatoid arthritis most often affects the small joints of the hands and feet but may develop in any joint. In addition to being painful, rheumatoid arthritis can destroy joints. About 1 of 10 persons with rheumatoid arthritis become disabled from joint destruction. No cure exists for rheumatoid arthritis, but the symptoms can be treated. Drugs used to treat rheumatoid arthritis include anti-inflammatory drugs, such as prednisone or sulfasalazine, and powerful drugs called disease-modifying antirheumatic drugs.

Because rheumatoid arthritis drugs have side effects and do not always completely relieve symptoms, many patients try alternative treatments, such as herbal therapies. In traditional Chinese medicine, extracts of the roots of the medicinal vine Tripterygium wilfordii Hook F (TwHF) (known as lei gong teng or thunder god vine) have shown promise in treating inflammatory conditions. The results of small studies suggest that TwHF may have some benefit in inflammatory conditions.

Why did the researchers do this particular study?

To see whether treatment with TwHF can help patients with rheumatoid arthritis.

Who was studied?

121 patients with active rheumatoid arthritis.

How was the study done?

The researchers randomly assigned patients to take either TwHF root extract, 60 mg 3 times per day, or sulfasalazine, 1 g twice per day, for 24 weeks. The researchers used a measure of joint involvement at 24 weeks to judge how well the treatments worked and also evaluated other outcomes, including side effects.

What did the researchers find?

At 24 weeks, more patients in the TwHF group than in the sulfasalazine group met the criteria for improvement in joint symptoms. Other outcomes suggested that patients receiving TwHF did better than those receiving sulfasalazine. Side effects occurred with similar frequency in both groups.

What were the limitations of the study?

Many patients withdrew before the study was finished. The study was too short to show whether TwHF also helped to prevent joint destruction.

What are the implications of the study?

The extract of the roots of TwHF seems effective in treating patients with active rheumatoid arthritis and may offer an alternative treatment approach.

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BMJ 2010;341:c5893-c1494.

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