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Oral herbal medicines marketed in Brazil for the treatment of osteoarthritis: A systematic review and meta-analysis.

Authors
  • Del Grossi Moura, Mariana1
  • Lopes, Luciane Cruz1
  • Biavatti, Maique Weber2
  • Kennedy, Sean Alexander3
  • de Oliveira E Silva, Maria Carolina1
  • Silva, Marcus Tolentino1
  • de Cássia Bergamaschi, Cristiane1
  • 1 Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo, Brazil. , (Brazil)
  • 2 Pharmaceutical Department, Federal University of Florianopolis, Florianopolis, Santa Catarina, Brazil. , (Brazil)
  • 3 Department of Medicine, McMaster University, Hamilton, Ontario, Canada. , (Canada)
Type
Published Article
Journal
Phytotherapy Research
Publisher
Wiley (John Wiley & Sons)
Publication Date
Nov 01, 2017
Volume
31
Issue
11
Pages
1676–1685
Identifiers
DOI: 10.1002/ptr.5910
PMID: 28872719
Source
Medline
Keywords
License
Unknown

Abstract

Herbal medications are commonly used to manage symptoms associated with osteoarthritis (OA). This systematic review evaluated the effectiveness and safety of oral medications used in Brazil for the treatment of OA. Randomized clinical trials involving adults with OA treated by a herbal medicine or a control group were eligible. The primary outcomes measured were pain, physical function, swelling, stiffness and quality of life; and the secondary outcomes were adverse events, activity limitations and treatment satisfaction. Sixteen studies were included (n = 1,741 patients) in the systematic review and nine studies in the meta-analysis, representing 6 of the 13 herbal medicines studied: Boswellia serrata (n = 2), Curcuma longa (n = 3), Harpagophytum procumbens (n = 1), Salix daphnoides (n = 3), Uncaria guianensis (n = 2) and Zingiber officinale (n = 5). B. serrata was more effective than both placebo and valdecoxib for improvement of pain and physical function. No difference was observed for H. procumbens, C. longa and U. guianensis compared with control. Z. officinale showed improvement of pain over placebo. The evidence was insufficient to support the effective and safe use of these herbal medicines, because the quality of evidence of studies was low. This study guides managers of the Brazilian public health system and prescribers in decision-making regarding the use of these herbal medicines for OA. Copyright © 2017 John Wiley & Sons, Ltd.

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