Abstract
Objective: Osteoarthritis (OA) is one of the most prevalent joint disorders in the world that has placed an enormous economic and social burden on governments and healthcare sectors in many countries. Hand OA (HOA) is the most common peripheral arthritis, which is less investigated than knee and hip OA. Due to limited approved drug choices and adverse effects of long-term use of current regimens, we aimed to review the existing evidence that were used as oral herbal medicine to treat HOA.
Methods: The PubMed database was searched for both observational and interventional studies that have investigated herbal medicine safety and efficacy in HOA, written in English and published between 2010 and 2022.
Results: A total of 5 original articles fulfilled the inclusion criteria, and each article assessed a different herbal regimen. Overall, it seems desirable to add specific herbal treatments to the regimen of HOA patients, specifically in case of early stages of HOA.
Conclusion: Currently, the need for a low-risk alternative treatment in HOA patients is felt more than ever. There are reliable references relating to the safety of Korean red ginseng, GCSB-5, XLGB, and GS-GCu in these patients, although their efficacy was limited. Additionally, herbs like curcumin and Boswellia serrata have positively affected patients with knee osteoarthritis. However, there is a lack of strong evidence supporting their effectiveness in hand osteoarthritis (HOA). This emphasizes the potential benefits that these herbs may have for HOA patients.
[1]
Long H, Liu Q, Yin H, et al. Prevalence trends of site-specific osteoarthritis from 1990 to 2019: findings from the Global Burden of Disease Study 2019. Arthritis Rheumatol 2022; 74(7): 1172-83.
[http://dx.doi.org/10.1002/art.42089] [PMID: 35233975]
[http://dx.doi.org/10.1002/art.42089] [PMID: 35233975]
[2]
Reginster JYL, Arden NK, Haugen IK, et al. Guidelines for the conduct of pharmacological clinical trials in hand osteoarthritis: Consensus of a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Elsevier: Amsterdam, Netherlands. 2018; pp. 1-8.
[3]
Goel S, Kamath SU, Annappa R, et al. Cross-sectional assessment of cardiovascular risk factors in patients with knee osteoarthritis. F1000 Res 2021; 10: 508.
[http://dx.doi.org/10.12688/f1000research.27744.2] [PMID: 35265321]
[http://dx.doi.org/10.12688/f1000research.27744.2] [PMID: 35265321]
[4]
Silvestre MP, Rodrigues AM, Canhão H, et al. Cross-talk between diet-associated dysbiosis and hand osteoarthritis. Nutrients 2020; 12(11): 3469.
[http://dx.doi.org/10.3390/nu12113469] [PMID: 33198220]
[http://dx.doi.org/10.3390/nu12113469] [PMID: 33198220]
[5]
Mobasheri A, Batt M. An update on the pathophysiology of osteoarthritis. Ann Phys Rehabil Med 2016; 59(5-6): 333-9.
[http://dx.doi.org/10.1016/j.rehab.2016.07.004] [PMID: 27546496]
[http://dx.doi.org/10.1016/j.rehab.2016.07.004] [PMID: 27546496]
[6]
Griffin TM, Scanzello CR. Innate inflammation and synovial macrophages in osteoarthritis pathophysiology. Clin Exp Rheumatol 2019; 37(5) (Suppl. 120): 57-63.
[PMID: 31621560]
[PMID: 31621560]
[7]
Molnar V, Matišić V, Kodvanj I, et al. Cytokines and chemokines involved in osteoarthritis pathogenesis. Int J Mol Sci 2021; 22(17): 9208.
[http://dx.doi.org/10.3390/ijms22179208] [PMID: 34502117]
[http://dx.doi.org/10.3390/ijms22179208] [PMID: 34502117]
[8]
Plotz B, Bomfim F, Sohail MA, Samuels J. Current epidemiology and risk factors for the development of hand osteoarthritis. Curr Rheumatol Rep 2021; 23(8): 61.
[http://dx.doi.org/10.1007/s11926-021-01025-7] [PMID: 34216294]
[http://dx.doi.org/10.1007/s11926-021-01025-7] [PMID: 34216294]
[9]
Favero M, Belluzzi E, Ortolan A, et al. Erosive hand osteoarthritis: latest findings and outlook. Nat Rev Rheumatol 2022; 18(3): 171-83.
[http://dx.doi.org/10.1038/s41584-021-00747-3] [PMID: 35105980]
[http://dx.doi.org/10.1038/s41584-021-00747-3] [PMID: 35105980]
[10]
Thissen GCE, van Middelkoop M, Colaris JW, et al. Subgroup effects of non-surgical and non-pharmacological treatment of patients with hand osteoarthritis: A protocol for an individual patient data meta-analysis. BMJ Open 2022; 12(1): e057156.
[http://dx.doi.org/10.1136/bmjopen-2021-057156] [PMID: 35039303]
[http://dx.doi.org/10.1136/bmjopen-2021-057156] [PMID: 35039303]
[11]
Reginster JY, Veronese N. Highly purified chondroitin sulfate: A literature review on clinical efficacy and pharmacoeconomic aspects in osteoarthritis treatment. Aging Clin Exp Res 2021; 33(1): 37-47.
[http://dx.doi.org/10.1007/s40520-020-01643-8] [PMID: 32638342]
[http://dx.doi.org/10.1007/s40520-020-01643-8] [PMID: 32638342]
[12]
Kloppenburg M, Kroon FPB, Blanco FJ, et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann Rheum Dis 2019; 78(1): 16-24.
[http://dx.doi.org/10.1136/annrheumdis-2018-213826] [PMID: 30154087]
[http://dx.doi.org/10.1136/annrheumdis-2018-213826] [PMID: 30154087]
[13]
Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol 2020; 72(2): 220-33.
[http://dx.doi.org/10.1002/art.41142] [PMID: 31908163]
[http://dx.doi.org/10.1002/art.41142] [PMID: 31908163]
[14]
Dabbagh A, MacDermid JC. Appraisal of Clinical Practice Guideline: 2018 update of the EULAR recommendations for the management of hand osteoarthritis. J Physiother 2021; 67(1): 68.
[http://dx.doi.org/10.1016/j.jphys.2020.07.002] [PMID: 32768184]
[http://dx.doi.org/10.1016/j.jphys.2020.07.002] [PMID: 32768184]
[15]
Gabay C, Medinger-Sadowski C, Gascon D, Kolo F, Finckh A. Symptomatic effects of chondroitin 4 and chondroitin 6 sulfate on hand osteoarthritis: A randomized, double-blind, placebo-controlled clinical trial at a single center. Arthritis Rheum 2011; 63(11): 3383-91.
[http://dx.doi.org/10.1002/art.30574] [PMID: 21898340]
[http://dx.doi.org/10.1002/art.30574] [PMID: 21898340]
[16]
Chevalier X, Eymard F, Richette P. Biologic agents in osteoarthritis: hopes and disappointments. Nat Rev Rheumatol 2013; 9(7): 400-10.
[http://dx.doi.org/10.1038/nrrheum.2013.44] [PMID: 23545735]
[http://dx.doi.org/10.1038/nrrheum.2013.44] [PMID: 23545735]
[17]
Kloppenburg M, Ramonda R, Bobacz K, et al. Etanercept in patients with inflammatory hand osteoarthritis (EHOA): A multicentre, randomised, double-blind, placebo-controlled trial. Ann Rheum Dis 2018; 77(12): 1757-64.
[http://dx.doi.org/10.1136/annrheumdis-2018-213202] [PMID: 30282670]
[http://dx.doi.org/10.1136/annrheumdis-2018-213202] [PMID: 30282670]
[18]
Persson MSM, Sarmanova A, Doherty M, Zhang W. Conventional and biologic disease-modifying anti-rheumatic drugs for osteoarthritis: A meta-analysis of randomized controlled trials. Rheumatology (Oxford) 2018; 57(10): 1830-7.
[http://dx.doi.org/10.1093/rheumatology/key131] [PMID: 29917100]
[http://dx.doi.org/10.1093/rheumatology/key131] [PMID: 29917100]
[19]
Kim HI, Chon SJ, Seon KE, Seo SK, Choi YR. Clinical effects of Korean red ginseng in postmenopausal women with hand osteoarthritis: A double-blind, randomized controlled trial. Front Pharmacol 2021; 12: 745568.
[http://dx.doi.org/10.3389/fphar.2021.745568] [PMID: 34858175]
[http://dx.doi.org/10.3389/fphar.2021.745568] [PMID: 34858175]
[20]
Liu X, Robbins S, Eyles J, et al. Efficacy and safety of a supplement combination on hand pain among people with symptomatic hand osteoarthritis an internet-based, randomised clinical trial the RADIANT study. Osteoarthr Cartil 2021; 29(5): 667-77.
[http://dx.doi.org/10.1016/j.joca.2021.01.011] [PMID: 33617972]
[http://dx.doi.org/10.1016/j.joca.2021.01.011] [PMID: 33617972]
[21]
Park JK, Shin K, Kang EH, et al. Efficacy and tolerability of GCSB-5 for hand osteoarthritis: A randomized, controlled trial. Clin Ther 2016; 38(8): 1858-1868.e2.
[http://dx.doi.org/10.1016/j.clinthera.2016.06.016] [PMID: 27449412]
[http://dx.doi.org/10.1016/j.clinthera.2016.06.016] [PMID: 27449412]
[22]
Wang F, Shi L, Zhang Y, et al. A traditional herbal formula Xianlinggubao for pain control and function improvement in patients with knee and hand osteoarthritis: A multicenter, randomized, open-label, controlled trial. Evid Based Complement Alternat Med 2018; 2018
[http://dx.doi.org/10.1155/2018/1827528]
[http://dx.doi.org/10.1155/2018/1827528]
[23]
Conrozier T, Renevier JL, Parisaux JM, Balblanc JC. Predictive factors of adherence to an association of glucosamine sulfate, copper, and ginger extracts in patients with symptomatic osteoarthritis: A prospective open-label French noninterventional study (the PREDOA study). Patient Prefer Adherence 2019; 13: 915-21.
[http://dx.doi.org/10.2147/PPA.S200892] [PMID: 31239649]
[http://dx.doi.org/10.2147/PPA.S200892] [PMID: 31239649]
[24]
Long L, Soeken K, Ernst E. Herbal medicines for the treatment of osteoarthritis: A systematic review. Rheumatology (Oxford) 2001; 40(7): 779-93.
[http://dx.doi.org/10.1093/rheumatology/40.7.779] [PMID: 11477283]
[http://dx.doi.org/10.1093/rheumatology/40.7.779] [PMID: 11477283]
[25]
Espejo-Antúnez L, Cardero-Durán MA, Garrido-Ardila EM, Torres-Piles S, Caro-Puértolas B. Clinical effectiveness of mud pack therapy in knee osteoarthritis. Rheumatology 2013; 52(4): 659-68.
[http://dx.doi.org/10.1093/rheumatology/kes322] [PMID: 23236190]
[http://dx.doi.org/10.1093/rheumatology/kes322] [PMID: 23236190]
[26]
Forestier R, Erol Forestier FB, Francon A. Spa therapy and knee osteoarthritis: A systematic review. Ann Phys Rehabil Med 2016; 59(3): 216-26.
[http://dx.doi.org/10.1016/j.rehab.2016.01.010] [PMID: 26996955]
[http://dx.doi.org/10.1016/j.rehab.2016.01.010] [PMID: 26996955]
[27]
De Luigi AJ. Complementary and alternative medicine in osteoarthritis. PM R 2012; 4(5) (Suppl.): S122-33.
[http://dx.doi.org/10.1016/j.pmrj.2012.01.012] [PMID: 22632691]
[http://dx.doi.org/10.1016/j.pmrj.2012.01.012] [PMID: 22632691]
[28]
Lee JH, Lim H, Shehzad O, Kim YS, Kim HP. Ginsenosides from Korean red ginseng inhibit matrix metalloproteinase-13 expression in articular chondrocytes and prevent cartilage degradation. Eur J Pharmacol 2014; 724: 145-51.
[http://dx.doi.org/10.1016/j.ejphar.2013.12.035] [PMID: 24384406]
[http://dx.doi.org/10.1016/j.ejphar.2013.12.035] [PMID: 24384406]
[29]
Kim KR, Chung TY, Shin H, et al. Red ginseng saponin extract attenuates murine collagen-induced arthritis by reducing pro-inflammatory responses and matrix metalloproteinase-3 expression. Biol Pharm Bull 2010; 33(4): 604-10.
[http://dx.doi.org/10.1248/bpb.33.604] [PMID: 20410593]
[http://dx.doi.org/10.1248/bpb.33.604] [PMID: 20410593]
[30]
Majeed M, Majeed S, Narayanan NK, Nagabhushanam K. A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee. Phytother Res 2019; 33(5): 1457-68.
[http://dx.doi.org/10.1002/ptr.6338] [PMID: 30838706]
[http://dx.doi.org/10.1002/ptr.6338] [PMID: 30838706]
[31]
Karlapudi V, Sunkara KB, Konda PR, Sarma KV, Rokkam MP. Efficacy and Safety of Aflapin®, a novel Boswellia serrata extract, in the treatment of osteoarthritis of the knee: A short-term 30-day randomized, double-blind, placebo-controlled clinical study. J Am Nutr Assoc 2021; 1-10.
[32]
Yu G, Xiang W, Zhang T, Zeng L, Yang K, Li J. Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: A systematic review and meta-analysis. BMC Complement Medi Ther 2020; 20(1): 225.
[http://dx.doi.org/10.1186/s12906-020-02985-6] [PMID: 32680575]
[http://dx.doi.org/10.1186/s12906-020-02985-6] [PMID: 32680575]
[33]
Liu X, Eyles J, McLachlan AJ, Mobasheri A. Which supplements can I recommend to my osteoarthritis patients? Rheumatology (Oxford) 2018; 57 (Suppl. 4): iv75-87.
[http://dx.doi.org/10.1093/rheumatology/key005] [PMID: 29506080]
[http://dx.doi.org/10.1093/rheumatology/key005] [PMID: 29506080]
[34]
Rohdewald PJ. Review on sustained relief of osteoarthritis symptoms with a proprietary extract from pine bark, Pycnogenol. J Med Food 2018; 21(1): 1-4.
[http://dx.doi.org/10.1089/jmf.2017.0015] [PMID: 28836883]
[http://dx.doi.org/10.1089/jmf.2017.0015] [PMID: 28836883]
[35]
Heffernan SM, McCarthy C, Eustace S, FitzPatrick RE, Delahunt E, De Vito G. Mineral rich algae with pine bark improved pain, physical function and analgesic use in mild-knee joint osteoarthritis, compared to Glucosamine: A randomized controlled pilot trial. Complement Ther Med 2020; 50: 102349.
[http://dx.doi.org/10.1016/j.ctim.2020.102349] [PMID: 32444040]
[http://dx.doi.org/10.1016/j.ctim.2020.102349] [PMID: 32444040]
[36]
Pagonis TA, Givissis PA, Kritis AC, Christodoulou AC. The effect of methylsulfonylmethane on osteoarthritic large joints and mobility. Int J Orthop 2014; 1(1): 19-24.
[37]
Debbi EM, Agar G, Fichman G, et al. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: A randomized controlled study. BMC Complement Altern Med 2011; 11(1): 50.
[http://dx.doi.org/10.1186/1472-6882-11-50] [PMID: 21708034]
[http://dx.doi.org/10.1186/1472-6882-11-50] [PMID: 21708034]
[38]
Hashemzadeh K, Davoudian N, Jaafari MR, Mirfeizi Z. The effect of nanocurcumin in improvement of knee osteoarthritis: A randomized clinical trial. Curr Rheumatol Rev 2020; 16(2): 158-64.
[http://dx.doi.org/10.2174/1874471013666191223152658] [PMID: 31868149]
[http://dx.doi.org/10.2174/1874471013666191223152658] [PMID: 31868149]
[39]
Nakagawa Y, Mukai S, Yamada S, et al. Short-term effects of highly-bioavailable curcumin for treating knee osteoarthritis: A randomized, double-blind, placebo-controlled prospective study. J Orthop Sci 2014; 19(6): 933-9.
[http://dx.doi.org/10.1007/s00776-014-0633-0] [PMID: 25308211]
[http://dx.doi.org/10.1007/s00776-014-0633-0] [PMID: 25308211]
[40]
Park YG, Ha CW, Han CD, et al. A prospective, randomized, double-blind, multicenter comparative study on the safety and efficacy of Celecoxib and GCSB-5, dried extracts of six herbs, for the treatment of osteoarthritis of knee joint. J Ethnopharmacol 2013; 149(3): 816-24.
[http://dx.doi.org/10.1016/j.jep.2013.08.008] [PMID: 23954277]
[http://dx.doi.org/10.1016/j.jep.2013.08.008] [PMID: 23954277]
[41]
Liu Y, DU J, Huang X. Glucosamine hydrochloride tablets alone and combination with Xianlinggubao capsules for treatment patients with knee osteoarthritis. Zhongguo Jiceng Yiyao 2015; 3044-7.
[42]
Araya-Quintanilla F, Gutierrez-Espinoza H, Munoz-Yanez MJ, Sanchez-Montoya U, Lopez-Jeldes J. Effectiveness of ginger on pain and function in knee osteoarthritis: A PRISMA systematic review and meta-analysis. Pain Physician 2020; 2(23): E151-63.
[http://dx.doi.org/10.36076/ppj.2020/23/E151] [PMID: 32214292]
[http://dx.doi.org/10.36076/ppj.2020/23/E151] [PMID: 32214292]
[43]
Dehghan M, Abdoli-Tafti A, Ganji F, Ghaedi R. Comparison the effects of ginger (Zingiber officinale) jelly and piroxicam jelly on pain of knee osteoarthritis. Majallah-i Ilmi-i Danishgah-i Ulum-i Pizishki-i Kurdistan 2018; 23(1): 8-17.
[44]
Knapik JJ, Pope R, Hoedebecke SS, Schram B, Orr R, Lieberman HR. Effects of oral glucosamine sulfate on osteoarthritis-related pain and joint-space changes: Systematic review and meta-analysis. J Spec Oper Med 2018; 18(4): 139-47.
[http://dx.doi.org/10.55460/AUC0-QM7H] [PMID: 30566740]
[http://dx.doi.org/10.55460/AUC0-QM7H] [PMID: 30566740]
[45]
Azadbakht Z, Sajedi F, Mahboobian MM, Mohammadi M, Ataei S. Analgesic effect of curcumin topical formulation in knee osteoarthritis patients: A clinical trial. J Basic Clin Physiol Pharmacol 2023; 34(1): 41-8.
[http://dx.doi.org/10.1515/jbcpp-2021-0255] [PMID: 35107231]
[http://dx.doi.org/10.1515/jbcpp-2021-0255] [PMID: 35107231]
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