By Michael A. Smith, MDThunder God Vine, scientifically known as T. wilfordii, took on a powerful prescription drug called methotrexate...and won.
Well, unfortunately, based on how the clinical study was designed, I can’t really say it won.
But I can say that T. wilfordii is just as effective as methotrexate in the short-term treatment of rheumatoid arthritis.
Let’s do this…I’ll present the results and you can declare the winner. Sound fair enough?
Testing T. Wilfordii’s Non-Inferiority for Rheumatoid ArthritisA non-inferiority test compares a newer ingredient to a proven one for a predetermined outcome of a given disease. The purpose is not to show that the newcomer is better, but that it’s just as good.
If it’s proven to be just as good as the established ingredient, than it should be considered by clinicians as a valid treatment option — especially if it has fewer side effects.
Well, that’s exactly what researchers did with T. wilfordii, published in the Annals of the Rheumatic Diseases. Thunder God Vine was just as good for short-term treatment of rheumatoid arthritis as the standard, side-effect prone, methotrexate.
T. Wilfordii Study Yields Impressive ResultsT. wilfordii, known in the West as Thunder God Vine, has long been utilized in China for its effects on joint pain, local inflammation, swelling, and fever, and is approved for the treatment of rheumatoid arthritis. The plant contains many active compounds, with diterpenoids being of primary interest.
At the Peking Union Medical College Hospital they enrolled 207 patients with active disease, randomizing them to receive 20 mg of T. wilfordii three times per day, methotrexate in doses beginning with 7.5 mg per week and increasing over a month to 12.5 mg per week, or both.
No placebo tablets were available, but assessments done at weeks 4, 12, and 24 were done by clinicians who were unaware of the assigned treatments. The mean age of the subjects was 51, most were women, and the average duration of disease was 4.9, 5.1, and 6.3 years in the groups treated with methotrexate, T. wilfordii, or the combination, respectively.
At 6 months, 46.4% of patients receiving methotrexate had improved by at least 50% on the American College of Rheumatology (ACR50) criteria, as had 55.1% of those receiving T. wilfordii and 76.8% of those given both.
The study showed that T. wilfordii monotherapy was not inferior to, and combination therapy of methotrexate and T. wilfordii was better than, methotrexate monotherapy in controlling disease activity in patients with active RA.1
T. Wilfordii Results in Fewer Adverse EffectsMethotrexate can cause severe bone marrow and immunosuppression, which in some cases results in opportunistic infections and even cancer. Granted this is a rare adverse effect, but it’s reported consistently in clinical trials. T. wilfordii has no such immunosuppression.
The most frequent side effects were gastrointestinal, reported by 43.5% of patients on methotrexate, 34.8% of those receiving the combination, and 29% of those given T. wilfordii.1
Interestingly, 15 (a little over 8%) of the female patients developed menstrual irregularities during the study. Seven of these were in the T. wilfordii group.
Our Verdict: Just as Good…and SaferThe bottom line is this: T. wilfordii is just as good at treating short-term rheumatoid arthritis as the standard of care, methotrexate. And it’s safer without severe immunosuppression.
So which one are you going to declare the winner?
- Ann Rheum Dis. 2014 Apr 14. doi: 10.1136/annrheumdis-2013-204807. [Epub ahead of print]
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