1. Herbal medicinal products used for the treatment of OA.
| PLANT | MEDICINAL PRODUCT | DOSE | MARKER | |||||
| Botanical name | Part/s | Tradename | Preparation | Drug:Extract | mg/day | Constituent marker | Quantity of marker | References |
| Medicinal products from single plants | ||||||||
| Boswellia serrata | gum resin | CapWokvelTM | extraction solvent not stated | not stated | 999 | boswellic acid (total organic acids 65%) |
40% | Kimmatkar 2003, Sontakke 2007 |
| 5‐Loxin | 100 or 250 | AKBA | 30% |
Sengupta 2008 Sengupta 2010 |
||||
| Aflapin | 100 | AKBA + non‐volatile oil | 20% |
Sengupta 2010 Vishal 2011 |
||||
| Curcuma domestica | root | study medication | ethanolic extract | not stated | curcumoids | 500mg | Kuptniratsaikul 2009 | |
| Derris scandens | stem | study medication | ethanolic (50%) extract | not stated | 800 | genistein derivatve | not stated | Kuptniratsaikul 2011 |
| Garcinia kola | seed | study medication | freeze‐dried aqueous extract | not stated | 400 | not stated | Adegbehingbe 2008 | |
| Harpagophytum procumbens | root | Arthrotabs | aqueous extract | 1.5‐2.5:1 | 2400 | harpagoside1 | 30 mg | Schmelz 1997. |
| Flexiloges | ethanolic (60%) extract | 4.5‐5.5:1 | 960 | <30 mg | Frerick 2001, Biller 2002. | |||
| Harpadol | cryoground powder | 2610 | 60 mg | Leblan 2000. | ||||
| Petiveria alliacea | herb | Tipi tea | aqueous extract | 9g / 600 ml | 600 ml | not stated | Ferraz 1991 | |
| Pinus pinaster (synonym Pinus maritima) | bark | Pycnogenol® | polyphenol concentrate | 150 | proanthocyanidins | 45 (90%) | Cisar 2008 | |
| 100 | not stated | Belcaro 2008 | ||||||
| 150 | 70% | Farid 2007 | ||||||
| Ricinus officinalis | seed | study medication | oil | not stated | 2,7 ml | ricinoleic acid | not stated | Medhi 2009 |
| Rosa canina lito | rose hip and seed | Hyben Vital or Litozin | powder | 5000 | galactolipid | 1.5mg |
Rein 2004aWarholm 2003 Winther 2005 |
|
| Salix daphnoides | bark | study medication | ethanolic (70%) extract | 8‐14:1 | 1573 | salicin | 240 mg | Biegert 2004. |
| Salix pupurea x daphnoides | bark | study medication | ethanolic (70%) extract2 | 10‐20:1 | 1360 | salicin | 240 mg | Schmid 2000. |
| Uncaria guianensis | bark | study medication | freeze‐dried aqueous extract | not stated | 100 | not stated | Piscoya 2001. | |
| Vitellaria paradoxa | seed | study medication | patented extract | not stated | 2250 | triterpenes | 75% | Cheras 2010 |
| Zingiber officinale3 | root | EV.EXT 33 | acetone extract3 | 20:1 | 510 | not stated | Bliddal 2000. | |
| Zingiber officinale | root | Zintona EC | CO2 extract | not stated | 1000 | gingerol | 40 mg | Wigler 2003 |
| Medicinal products from two plants | ||||||||
| Boswellia carteri + Curcuma longa | gum + root | study medication | extract, solvent not stated | not stated | not stated | boswellic acid | 37.5% | Badria 2002 |
| Persea gratissma (P) + Glycine max (G) | oils | Piascledine 300 | unsaponifiable fraction 1/3 P;2/3 G | 300 or 600 | not stated | Appelboom 2001, Blotman 1997, Lequesne 2002, Maheu 1998, Maheu 2013. | ||
| Phellondenron amurense + Citrus sinensis | bark peel |
NP 06‐1 | extract, solvent not stated | not stated | 370 mixture | berberine polymethoxylated flavones |
50% 30% |
Oben 2009 |
| Uncaria guianensis + Lepidium meyenii | bark | Reparagen® | freeze‐dried aqueous extract | not stated | 1500 300 |
not stated | Mehta 2007 | |
| Zingiber officinale + Alpinia galanga | root | EV.EXT 77 | acetone extract3 | 20:1 | not stated | not stated | Altman 2001 | |
| Medicinal products from three or more plants | ||||||||
| Clematis mandshurica + Prunella vulgaris + Trichosanthes kirilowii | root, flower, root; 1:1:2 | SKI306X | ethanol 30% extracts, thereafter butanol extraction | 7:1 | 600‐1800 | oleanolic acid 4%, rosmarinic acids 0.2%, ursolic acids 0.5%, hydroxybenzoic acid 0.03%, hydroxymethoxybenzoic acid 0.03%, trans‐cinnamic acid 0.05% | Jung 2001, Jung 2004. | |
| Fraxinus excelsior | bark | Phytodolor | fresh plant ethanolic (45,6%) extract | 3:1:1 | 5‐8 ml | total flavonoids | 0.34 ‐ 0.56 mg | Bernhardt 1991, Huber 1991, Schadler 1988. |
| salicyl alcohol | 0.48 ‐ 0.8 mg | |||||||
| Solidago virgaurea | herb | isofraxidin | 0.67 ‐ 1.1 mg | |||||
| Populus tremula | bark and leaf | salicin | 4.8 ‐ 8 mg | |||||
| Salix alba | bark | Reumalex | powder | 200 | salicin | 40‐80mg | Mills 1996 | |
| Guaiacun officinale | resin | powder | 80 | |||||
| Cimicifuga racemosa | root | powder | 70 | |||||
| Smilax (species not stated) | root | extract, solvent not stated | 4:1 | 50 | ||||
| Populus (species not stated) | bark | extract, solvent not stated | 7:1 | 34 | ||||
| Chinese mixture4 | herb | Duhuo Jisheng Wan | powder | 3 x 3 g | not stated | Teekachunhatean 2004. | ||
| Paeoniae alba | root | Chinese mixture: Blood nourishing, hard softening (BNHS) |
extract, solvent not stated | not stated | 3150 | paconiflorin | not stated | Cao 2005 |
| Gentiana macrophylla | gentianine | |||||||
| Glycyrrhiza (species not stated) | not stated | |||||||
| Auryvedic formaulae5 | powder | not stated | 1000 | total gingerols | not stated | Chopra 2011 | ||
| Zingiber officinale | rhizome | component of formulae A, B, C, D, and E | ||||||
| Tinospora cordifolia | stem | component of formulae A, B, C, D, and E | aqueous extract | 220 | tinosporosides | not stated | ||
| Withania somnifera | root | component of formulae B and E | aqueous extract | 600 | total withanolides | not stated | ||
| Emblica officinale | fruit | component of formulae C | aqueous extract | 500 | tannins galic acid |
not stated | ||
| Tribulus terrestris | fruit | component of formulae A and B | aqueous extract | 216 | total saponins | not stated | ||
| Ayuvedic formula6 | Antarth3 (for sandhigata vata) | not stated | not stated | not stated | not stated | Gupta 2011 | ||
| Ayuvedic formula | RA‐11 | not stated | not stated | not stated | not stated | Chopra 2004 | ||
| Ayuvedic formula | SGC | Chopra 2013 | ||||||
| Ayuvedic | SGCG | Chopra 2013 | ||||||
| Japanese mixture7 | Boiogito | not stated | not stated | 7.5g | not stated | not stated | Majima 2012 | |
1. Harpagoside content estimated indirectly and approximately from iridoid glycoside content in daily dose of raw material (Sporer 1999).
2. Ethanolic extract stated in unpublished thesis but not in published paper (Schmid 1998b).
3. Information provided by manufacturer but not reported in paper.
4. Chinese herbal medicine contains 7.75% each of: radix angelicae pubescentiis, radix gentianae macrophyllae, cortex eucommiae, radix achyranthis bidentatae, radix angelicae sinensis, herba taxilli, radix rehmanniae preparata, rhizoma chuanxiong, cortex cinnamomi, radix ledebouriellae. 5% each of: radix paeoniae alba, radix codonopis, radix glycyrrhizae, poria. 2.5% herba asari.
5. All Ayurvedic formulae A‐E contain Zingiber officinale (dried rhizome powder, total gingerols as marker), and Tinospora cordifolia (dried stem aqueous extract, marker tinosporosides). Some formulae also included Emblica officinale, Withania somnifera, or Tribulus terrestris. Drug:extract ratio and marker content not stated.
6. Ayurvedic phytomedicine Antarth contains Boswellia serrata, Commiphora mukul, Curcuma longa and Vitex negundo, Alpinia galangal, Withania somnifera, Tribulus terrestris, and Tinospora cordifolia.
7. Japanese herbal medicine Boiogito contains Sinomenium acutum, Astragalus (species not stated) root, Atractylodes lancea rhizome, Jujube (probably Ziziphus zizyphus), Glycyrrhiza (species not stated), and ginger (species not stated, probably Zingiber officinale).