Effect of Artemisia annua extract on treating active rheumatoid arthritis: A randomized controlled trial

Min Yang; Ming-yang Guo; Yong Luo; Ming-dong Yun; Jiao Yan; Tao Liu; Chang-hong Xiao

doi:10.1007/s11655-016-2650-7

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Effect of Artemisia annua extract on treating active rheumatoid arthritis: A randomized controlled trial

Updated：2021-08-27

- Effect of Artemisia annua extract on treating active rheumatoid arthritis: A randomized controlled trial
- Chinese Journal of Integrative Medicine Vol. 23, Issue 7, Pages: 496-503(2017)
- Affiliations：
  
  1. Department of Traditional Chinese Medicine, Rheumatology Center of Integrated Traditional and Western Medicine, General Hospital of Chengdu Military Area Command PLA,Chengdu,China
  2. Department of Internal Medicine, School of Traditional Chinese Medicine, Southern Medical University,Guangzhou,China
- Author bio：
- Funds：
  
  Supported by the National Natural Science Foundation of China (No. 810726), the Scientific Research Grants Program of Sichuan Provincial Administration of Traditional Chinese Medicine (No. 2012-E-063), the "Twelfth Five-Year Plan" Scientific Research Funds Project of Chinese PLA (No. BWS11J067), and the Hospital Program Fund for Research Talents (No. 2013YG-B007)
- DOI：10.1007/s11655-016-2650-7
  CLC：
- Published：2017，
  
  Published Online：29 December 2016，
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Yang, M., Guo, My., Luo, Y. et al. Effect of Artemisia annua extract on treating active rheumatoid arthritis: A randomized controlled trial., Chin. J. Integr. Med. 23, 496–503 (2017). https://doi.org/10.1007/s11655-016-2650-7

Min Yang, Ming-yang Guo, Yong Luo, et al. Effect of Artemisia annua extract on treating active rheumatoid arthritis: A randomized controlled trial. [J]. Chinese Journal of Integrative Medicine 23(7):496-503(2017)
Yang, M., Guo, My., Luo, Y. et al. Effect of Artemisia annua extract on treating active rheumatoid arthritis: A randomized controlled trial., Chin. J. Integr. Med. 23, 496–503 (2017). https://doi.org/10.1007/s11655-016-2650-7 DOI：

Min Yang, Ming-yang Guo, Yong Luo, et al. Effect of Artemisia annua extract on treating active rheumatoid arthritis: A randomized controlled trial. [J]. Chinese Journal of Integrative Medicine 23(7):496-503(2017) DOI： 10.1007/s11655-016-2650-7.

摘要

To investigate the effect and safety of the complementary use of the extract of Artemisia annua L. (EAA) on treating active rheumatoid arthritis (RA). A randomized controlled clinical trial was performed. All the 159 participates with active RA were randomly assigned to the control group (80 cases) and EAA group (79 cases) using concealed random allocation method. In the control group

patients were medicated with leflflunomide and methotrexate for 48 weeks; and patients in the EAA group were administrated with leflflunomide

methotrexate plus EAA (30 g/d). At the time points of 0

24 and 48 weeks

the clinical outcome measures

including objective pain score

tenderness score

number of painful joints

number of swollen joints

health assessment questionnaire (HAQ) score for quality of life

levels of serum rheumatoid factor (RF)

anti-cyclic citrullinated protein antibodies (CCP-Ab)

erythrocyte sedimentation rate (ESR)

C reactive protein (CRP)

visual analogue score for pain (VAS)

and the overall effificacy were detected and recorded. The objective pain score

number of painful joints and ESR at 12 weeks

tenderness score and HAQ at 24 weeks

and the tenderness score

number of painfull joints

number of swollen joints

HAQ

CRP

RF and CCP-Ab at 48 weeks were signifificantly improved in the EAA group compared with the control group (P<0.01 or P<0.05). At 24 and 48 weeks

the overall effificacy of the EAA group was signifificantly higher than the control group (P<0.01). There were signifificantly higher withdrawal rate of corticosteroids within 12 weeks post-treatment and lower incidence rate of adverse effects in the EAA group compared with the control group (P<0.01 or P<0.05). EAA plus methotrexate and leflflunomide were more effective and safer than the routine use of methotrexate and leflflunomide in the treatment of active RA.

Abstract

patients were medicated with leflflunomide and methotrexate for 48 weeks; and patients in the EAA group were administrated with leflflunomide

methotrexate plus EAA (30 g/d). At the time points of 0

24 and 48 weeks

the clinical outcome measures

including objective pain score

tenderness score

number of painful joints

number of swollen joints

health assessment questionnaire (HAQ) score for quality of life

levels of serum rheumatoid factor (RF)

anti-cyclic citrullinated protein antibodies (CCP-Ab)

erythrocyte sedimentation rate (ESR)

C reactive protein (CRP)

visual analogue score for pain (VAS)

and the overall effificacy were detected and recorded. The objective pain score

number of painful joints and ESR at 12 weeks

tenderness score and HAQ at 24 weeks

and the tenderness score

number of painfull joints

number of swollen joints

HAQ

CRP

RF and CCP-Ab at 48 weeks were signifificantly improved in the EAA group compared with the control group (P<0.01 or P<0.05). At 24 and 48 weeks

关键词

rheumatoid arthritisleflflunomidemethotrexateArtemisia annuaChinese Medicine

Keywords

rheumatoid arthritisleflflunomidemethotrexateArtemisia annuaChinese Medicine

references

Eriksson JK, Neovius M, Ernestam S, Lindblad S, Simard JF, Askling J. Incidence of rheumatoid arthritis in Sweden—a nationwide population-based assessment of incidence, its determinants, and treatment penetration. Arthritis Care Res (Hoboken) 2012;65:870–878.

Tobon GJ, Youinou P, Saraux A. The environment, geoepidemiology, and autoimmune disease: rheumatoid arthritis. J Autoimmun 2010;35:10–14.

Xu C, Wang X, Mu R, Yang L, Zhang Y, Han S, et al. Societal costs of rheumatoid arthritis in China: a hospital-based crosssectional study. Arthritis Care Res (Hoboken) 2013;66:523–531.

Dowman B, Campbell RM, Zgaga L, Adeloye D, Chan KY. Estimating the burden of rheumatoid arthritis in Africa: a systematic analysis. J Glob Health 2012;2:20406.

Tarride JE, Haq M, Nakhai-Pour HR, O'Reilly DJ, Xie F, Dolovich L, et al. The excess burden of rheumatoid arthritis in Ontario, Canada. Clin Exp Rheumatol 2013;31:18–24.

Yang M, Xiao CH, Wu QF, Niu MC, Yao Q, Li KQ, et al. Anti-inflammatory effect of Sanshuibaihu Decoction may be associated with nuclear factor-kappa B and p38 MAPK alpha in collagen-induced arthritis in rat. J Ethnopharmacol 2010;127:264–273.

Verschueren PC, Lories RJ, Daans M, Theate I, Durez P, Westhovens R, et al. Detection, identification and in vivo treatment responsiveness of bone morphogenetic protein (BMP)-activated cell populations in the synovium of patients with rheumatoid arthritis. Ann Rheum Dis 2009;68:117–123.

Zhang P, Li J, Han Y, Yu XW, Qin L. Traditional Chinese medicine in the treatment of rheumatoid arthritis: a general review. Rheumatol Int 2010;30:713–718.

Shakir L, Hussain M, Javeed A, Ashraf M, Riaz A. Artemisinins and immune system. Eur J Pharmacol 2011;668:6–14.

Wang JX, Tang W, Zhou R, Wan J, Shi LP, Zhang Y, et al. The new water-soluble artemisinin derivative SM905 ameliorates collagen-induced arthritis by suppression of inflammatory and Th17 responses. Br J Pharmacol 2008;153:1303–1310.

Cuzzocrea S, Saadat F, Di Paola R, Mirshafiey A. Artemether: a new therapeutic strategy in experimental rheumatoid arthritis. Immunopharmacol Immunotoxicol 2005;27:615–630.

Aldieri E, Atragene D, Bergandi L, Riganti C, Costamagna C, Bosia A, et al. Artemisinin inhibits inducible nitric oxide synthase and nuclear factor NF-κB activation. FEBS Lett 2003;552:141–144.

Wang JX, Hou LF, Yang Y, Tang W, Li Y, Zuo JP. SM905, an artemisinin derivative, inhibited NO and pro-inflammatory cytokine production by suppressing MAPK and NF-kappaB pathways in RAW 264.7 macrophages. Acta Pharmacol Sin 2009;30:1428–1435.

Konkimalla VB, Blunder M, Korn B, Soomro SA, Jansen H, Chang W, et al. Effect of artemisinins and other endoperoxides on nitric oxide-related signaling pathway in RAW 264.7 mouse macrophage cells. Nitric Oxide 2008;19:184–191.

Li B, Li J, Pan X, Ding G, Cao H, Jiang W, et al. Artesunate protects sepsis model mice challenged with Staphylococcus aureus by decreasing TNF-alpha release via inhibition TLR2 and Nod2 mRNA expressions and transcription factor NF-kappaB activation. Int Immunopharmacol 2010;10:344–350.

Xu H, He Y, Yang X, Liang L, Zhan Z, Ye Y, et al. Antimalarial agent artesunate inhibits TNF-alpha-induced production of proinflammatory cytokines via inhibition of NF-kappaB and PI3 kinase/Akt signal pathway in human rheumatoid arthritis fibroblast-like synoviocytes. Rheumatology (Oxford) 2007;46:920–926.

Hou LF, He SJ, Wang JX, Yang Y, Zhu FH, Zhou Y, et al. SM934, a water-soluble derivative of arteminisin, exerts immunosuppressive functions in vitro and in vivo. Int Immunopharmacol 2009;9:1509–1517.

Prato M, Gallo V, Giribaldi G, Aldieri E, Arese P. Role of the NFkappaB transcription pathway in the haemozoin-and 15-HETEmediated activation of matrix metalloproteinase-9 in human adherent monocytes. Cell Microbiol 2010;12:1780–1791.

Zhu C, Xiong Z, Chen X, Peng F, Hu X, Chen Y, et al. Artemisinin attenuates lipopolysaccharide-stimulated proinflammatory responses by inhibiting NF-kappaB pathway in microglia cells. PLoS One 2012;7:e35125.

Cui XJ, Wang YY, Hou XQ, Pan L, Fu JX. Clinical observation of artesunate in treating rheumatoid arthritis. Chin J Hospit Pharm (Chin) 2007;27:645–647.

Wei S, Xu GG. Clinical observation of artesunate in treating rheumatoid arthritis. Shanxi Med J (Chin) 2008;37:457–458.

Gu WH. Clinical trial of the combined effect of Artemisia annua and methotrexate in treating rheumatoid arthritis. Contempor Med (Chin) 2011;17:155–156.

Zhou R. Clinical observation on treating rheumatoid arthritis with Artemisia annua plus methotrexate. Clin J Chin Med (Chin) 2011;3:24.

Li Y, Zhou JG, Yu XJ, Hu JP, Wu TT. Clinical study on rheumatoid arthritis treated with Abrotani Herba and methotrexat. China Pharmaceut (Chin) 2011;20:3–4.

Kay J, Upchurch KS. ACR/EULAR 2010 rheumatoid arthritis classification criteria. Rheumatology (Oxford) 2012;51(Suppl 6):vi5–9.

Son KM, Song SH, Lim SK, Seo YI, Kim HA. Characteristics of patients with rheumatoid arthritis in clinical remission: the many aspects of DAS28 remission. Clin Exp Rheumatol 2012;30:947–950.

Ranganath VK, Khanna D, Paulus HE. ACR remission criteria and response criteria. Clin Exp Rheumatol 2006;24(Suppl 43):S14–S21.

Smolen JS, Landew R, Breedveld FC, Dougados M, Emery P, Gaujoux-Viala C, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheumatc Diss 2010;69:964–975.

O'Mahony R, Richards A, Deighton C, Scott D. Withdrawal of disease-modifying antirheumatic drugs in patients with rheumatoid arthritis: a systematic review and meta-analysis. Ann Rheum Dis 2010;69:1823–1826.

Salt E, Frazier SK. Adherence to disease-modifying antirheumatic drugs in patients with rheumatoid arthritis: a narrative review of the literature. Orthopaed Nurs 2010;29:260–275.

Umicevic Mirkov M, Coenen MJ. Pharmacogenetics of disease-modifying antirheumatic drugs in rheumatoid arthritis: towards personalized medicine. Pharmacogenomics 2013;14:425–444.

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