Abstract
Recently, there has been a boom in the use of complementary and alternative medicine in arthritis patients. In a 2006 Japanese report, the annual turnover of glucosamine was 15 billion and a shark cartilage (chondroitin) is 2 billion, although the clinical evidence for the use of glucosamine and chondroitin exisit for osteoarthritis (OA), no such evidence exist for rheumatoid arthritis (RA). Though a multicenter collaboration study, we administered glucosamine/chondroitin to 22 RA patients and 46 OA patients for 3 months. Although partial of improvements were found in OA, no efficacy was seen at all in RA. To examine the effect of oral hyaluronic acid (HA), the HA concentration of the knee joint was measured after HA was administered orally to 6 rabbits for 7 days. There was no HA concentration difference between the HA treatment group and control group. There is an antiinflammatory effect with bromelain, and there is an antioxidant action in quercetin or selenium. However, there is no clinical evidence that these are effective compared with non-steroidal antiinflammatory drugs (NSAIDs) or any of the existing anti-oxidization agents. Although the herbal remedies have been used as an alternative painkiller for many years, some of them (cats claw, feverfew and white willow etc.) increase hemorrhagic tendency, and they should be administered with care in some patients (pregnant woman or digestive ulcer patient etc.). Folic acid and vitamin B6 are effective for adverse reactions associated with methotrexate (MTX), vitamin B5 is also effective for morning stiffness and arthritic pain. Omega 3 fatty acids have an antiinflammatory effect and have improved on clinical symptoms, blood data and inflammatory cytokine levels in RA patients. Although complementary and alternative medicines are occasionally effective, they are not a radical treatment and there is also the problem of cost or side effects (herbal therapy etc.), so they are not strongly recommended in RA patients.
