A Chinese Herb That Works in Rheumatoid Arthritis

Rheumatoid arthritis is an inflammation of the joints, causing them to be swollen and painful. Treatment may slow joint damage and help reduce the risk of disability, but there is no cure for this distressing disease.  An anti-inflammatory drug used to treat the symptoms is sulfasalazine, and this was used as a control drug in a randomized clinical trial of a Chinese herb, Tripterygium wilfordii Hook F. The results of this trial have been reported in the Annals of Internal Medicine.

The herbal extract (shortened to TwHF, also known as "thunder god vine" or "lei gong teng") is used in traditional Chinese medicine to treat inflammatory conditions.

Over 120 adults with active rheumatoid arthritis were randomly assigned to receive TwHF (180 mg) or sulfasalazine (2 g), daily for 24 weeks.  They were able to add prednisone (a steroid anti-inflammatory) if necessary, but not any more powerful drugs (i.e .so-called disease-modifying anti-rheumatic drugs or DMARDS).

Many patients withdrew before the 24 weeks was completed – almost half – with slightly more in the sulfasalazine group. Significantly more patients taking TwHF achieved at least a 20% improvement in their symptoms than those sulfasalazine (65% vs. 33%).  There was no difference between the two groups with respect to adverse events.

It’s a pleasure to report encouraging results from a traditional Chinese medicine derived from an herb. Three of the herb’s constituents - triptolide, tripdiolide, and triptonide – have been reported to have anti-inflammatory and immunosuppressive effects, and may form the basis for a whole new line of drug research.