Table 2.
Recent clinical trials involving herbal medicines.
| Herbs | Patient Groups | Dosage | Follow-up | Outcome of Intervention | Ref |
|---|---|---|---|---|---|
| Boswellia spp. | |||||
| Boswellia serrata extract (3-acetyl-11-keto-β-boswellic acid and β-boswellic acid) | BSE n = 22; placebo n = 20 |
Boswellic acid 174.6 mg oral twice daily | 120 days | Reduction of OA joint pain and stiffness; improvement in knee joint gap and osteophytes. | [25] |
| Boswellia serrata extract (Boswellin Super) | BS n = 24; placebo n = 24 |
Boswellin Super 100 mg oral daily | 56 days | OA VAS, JKOM, and WOMAC improvements vs. placebo. | [26] |
| Boswellia Carterri B (Oliban oil) | oliban oil n = 51; diclofenac n = 51; sesame oil control n = 52 |
Oliban oil: 10 drops topically twice daily | 42 days | Reduction in OA pain and symptoms vs. control and diclofenac. No effect on activities of daily living, sport and recreation, and knee-related quality of life. | [27] |
| Curcuma spp. | |||||
| Curcuminoid complex | curmcuminoid complex + disclofenac n = 71; diclofenac n = 69 |
Diclofenac 50 mg with or without 500 mg curcuminoid complex, twice daily | 28 days | Curcuminoid complex + diclofenac showed better improvement in KOOS subscales, viz. pain, quality of life, and less adverse effects vs. diclofenac group. | [31] |
| Curcuma domestica extract | CD extract n = 185; ibuprofen n = 182 |
CD extract 1500 mg/day; ibuprofen 1200 mg/day | 28 days | Improvement of WOMAC pain and function scores and non-inferiority to ibuprofen for knee OA; significantly less abdominal pain and discomfort vs. ibuprofen. | [32] |
| Curcumin | curcumin n = 70; diclofenac n =69 |
Curcumin 1500 mg/day oral; Diclofenac 100 mg/day oral | 28 days | Overall efficacy comparable to diclofenac for OA; weight-lowering, anti-ulcer effect, and reduced requirement for H2 blockers. | [33] |
| Curcumin (Theracurmin) | curcumin n = 18; placebo n = 23 |
Curcumin 180 mg/day oral | 56 days | Reduced OA knee pain VAS scores, but no effect on JKOM scores vs. placebo; Reduced celecoxib dependence. | [34] |
| Eremostachys laciniata | |||||
| Eremostachys laciniata | EL n = 67; piroxicam n = 70 |
0.5% topical ointment | 14 days | Reduction in VAS pain scores and joint inflammation for arthritis and RA vs. control and piroxicam; quicker therapeutic response than piroxicam at 1 week; comparable response to piroxicam at 2 weeks | [35] |
| Eucommia ulmoides | |||||
| Eucommia | Eucommia + meloxicam n = 70; meloxicam n = 70 |
Meloxicam 15 mg with or without 36 g Eucommia daily | 28 days | Enhanced performance of meloxicam on the reduction of pain stiffness, and dysfunction. | [44] |
| Cortex Eucommiae extract | Recruiting | 1 g/day of E. ulmoides Oliver extract | 84 days | Ongoing. | [45] |
| Matricaria chamomilla L. | |||||
| Matricaria chamomilla oil | MC oil n = 28; diclofenac n = 28; placebo n = 28 |
30 mL of oil containing 600 g dried chamomilla flowers; 1% diclofenac gel | 21 days | Reduction in need for acetaminophen. | [46] |
| Chamomile tea | chamomile tea n = 20; placebo n = 15 |
6 g/day Chamomile tea as two tea bags twice daily | 42 days | Reduction in tender joints, ESR, and inflammation. | [47] |
| Paeonia lactiflora | |||||
| Total glucosides of paeony (TGP) | TGP n = 105; control n = 89 | TGP group: TGP 1.8 g/day + MTX 10mg/week + LEF 20 mg/day; Control group: MTX 10 mg/week + LEF 20 mg/day | 168 days | Reduced hepatotoxicity, alanine aminotransferase, and aspartate aminotransferase. | [6] |
| Tripterygium wilfordii Hook F | |||||
| Tripterygium wilfordii root ethyl acetate extracts | n = 13 | dose escalations starting at 30mg/day up to highest tolerated dose or 570mg/day | 112 days | EA extract of TwHF at doses > 360mg/day showed improvement in both clinical manifestations and laboratory findings. | [48] |
| Tripterygium wilfordii root ethanol/ethyl acetate extracts | placebo n = 12; low-dose n = 12; high-dose n = 11 |
placebo or low-dose (180 mg/day) or high-dose (360 mg/day) extract |
140 days | Both low- and high-dose of TwHF extract showed improvement of symptoms and signs of inflammation and physical functioning and was well tolerated. | [49] |
| Tripterygium wilfordii Hook F extract | TwHF group n = 60; sulfasalazine n = 60 |
TwHF extract: 180 mg/day; sulfasalazine: 2 g/day | 168 days | Higher rate for ACR 20, 50, and 70 response criteria; reduced IL-6 levels. | [50] |
| Withania somnifera | |||||
| Withania somnifera root aqueous extract | n = 11 | 8 days | Chondroprotective effect on damaged human osteoarthritis cartilage matrix. | [51] | |
| Withania somnifera root aqueous extract |
W. somnifera 250 mg n = 20; W. somnifera 125 mg n = 20; placebo n = 20 |
W. somnifera 250 mg or W. somnifera 125 mg or identical placebo twice daily |
28 days | W. somnifera (both 125 and 250 mg) reduced pain, stiffness, disability, modified WOMAC score, and knee swelling index. | [52] |
| Zingiber officinale | |||||
| Zingiber officinale (Ginger) extract | ginger n = 103; placebo n = 101 |
zintoma capsules containing 250 mg powdered ginger | 42 days | Reduced pain according to WOMAC; reduction in morning stiffness; no difference in side effects vs. placebo. | [53] |
| Zingiber officinale (Ginger) extracts in NLC | ginger n = 59; diclofenac n = 59 |
ginger extract in NLC with 5% ginger extract by weight; 1% diclofenac | 84 days | Improved knee pain, stiffness, physical function, and PGA. | [54] |
| Zingiber officinale (Ginger) extract | ginger n = 37; rx drugs from specialist n = 40 |
1000 mg/day orally | 84 days | Reduced pain scores; increased patient satisfaction. | [55] |
| Zingiber officinale (Ginger) extract | ginger extract n = 40; placebo n = 40; ibuprofen n = 40 |
ginger extract: 30 mg/day; ibuprofen: 3 × 400 mg/day | 30 days | Reduced VAS scores and gelling or regressive pain. | [56] |
| Concentrated Ginger extract | ginger extract n = 124; placebo n = 123 |
2 × 255 mg of ginger extract; placebo: coconut oil | 42 days | Reduced knee pain on standing and after walking, WOMAC index, and request of rescue medication; improved quality of life. | [57] |