If you've been stocking up on herbal remedies such as glucosamine or MSM to treat your arthritis, it could be in vain. Researchers have discovered that proteins, anti-cyclic citrullinated peptide antibody (ACPA) - highly specific and sensitive markers for rheumatoid arthritis - may be able to predict how well someone responds to herbal medicines for arthritis.

Over the past five years Americans' use of complementary and alternative medicine (CAM) has remained steady. About 38 percent of adults over age 18 and nearly 12 percent of children 17 years old or younger use CAM, according to the 2007 National Health Interview Survey (NHIS), an annual study based on interviews with thousands of Americans on their health and illness-related experiences. The study, which was developed by the National Center for Complementary and Alternative Medicine (NCCAM and the National Center for Health Statistics (NCHS), includes questions on 36 types of CAM therapies commonly used in the U.S.

"The 2007 NHIS provides the most current, comprehensive, and reliable source of information on Americans' use of CAM," said Josephine P. Briggs, M.D., director of NCCAM. "These statistics confirm that CAM practices are a frequently used component of Americans' health care regimens, and reinforce the need for rigorous research to study the safety and effectiveness of these therapies. The data also point out the need for patients and health care providers to openly discuss CAM use to ensure safe and coordinated care."

Herbal medicines for arthritis - such as glucosamine, chondroitin and fish oil - are among the most commonly used types of CAM. Arthritis is one of the main conditions people use natural remedies to treat when medicinal treatments aren't as effective. But, like pharmaceutical drugs, herbal supplements aren't as effective for everyone who uses them.

Recently, researchers may have found a way to predict how well someone is likely to respond to herbal medicines for arthritis. A study in Japan found that pretreatment blood levels of anti-cyclic citrullinated peptide antibody can be effective at predicting a good response to treatment with traditional herbal medicines (THM) in patients with rheumatoid arthritis.  

In the study, the team assessed 34 RA patients who received keishinieppiittokaryojutsubu (KER), a THM that contains several herbs. Just over 41 percent of patients were defined as responders and 13 were non-responders based on disease activity score in 28 joints (DAS28) and C-reactive protein results. Seven patients were excluded from the assessment because they sustained low disease activity during the 12-month study.

Blood analysis showed that levels of ACPA before treatment were significantly lower in patients who responded to KER than in non-responders, and there were no other differences in clinical measures between the two groups at the beginning of the study.

Also, the blood levels of ACPA in patients who responded to KER significantly dropped at six months compared to the beginning of the study, and continued to gradually decrease between six and 12 months. By comparison, there was no decrease in ACPA levels of patients who didn't respond to KER. Study leader Toshiaki Kogure and his team conclude that "low pretreatment levels of serum ACPA are associated with a more favorable response to KER treatment for RA."

As the researchers explain, it takes four to eight weeks to evaluate the effect of traditional herbal medicines for arthritis, which means that joint damage continues to occur in people who don't respond to treatment. For that reason, it's important to be able to identify predictors of treatment response to THM so medical professionals can better guide individual treatment decisions of people with rheumatoid arthritis.

Study References:

Journal Name: Rheumatology International,

Study Date: Published online February 22, 2009

Study Name: Serum levels of anti-cyclic citrullinated peptide antibodies are associated with a beneficial response to traditional herbal medicine (Kampo) in rheumatoid arthritis

Website: http://www.springerlink.com/content/f84158647v7702w3/?p=d9adaf5cf775437da4cfbe723cb3b029&pi=0

Authors: Toshiaki Kogure, Hiroko Sato, Daijiro Kishi, Tomoyuki Ito and Takeshi Tatsumi