Comparative Study of Pharmacotherapy with Alternate Systems of Medicine in Rheumatoid Arthritis

Abstract

A study was carried out in RA patients of South Tamil Nadu, India wherein the demographic characteristics, aetiology, response to Allopathic, Ayurvedic and Pranic Healing treatment was evaluated. Oxidative stress, antioxidant levels and immunologic factors of RA were studied in these patients. Also, the economic burden of RA was evaluated. Greater number of women patients than men constituted the study population with a female, male ratio of 4.134:1. Age of onset of disease was 30-45 years in majority of patients. Onset was insidious in nature. Genetic susceptibility, chronic infection, low oestrogen level were common causative factors of the disease. Sedentary life style, unhygienic environment were aggravating factors of RA. More common extra-articular complications were subcutaneous nodules, vasculitis and mild cardiac dysfunction. Patients consulted Rheumatologists 6-18 months after onset of disease, causing a delay in initiation of DMARD treatment. RA patients responded well to DMARD, with significant improvement in functional ability, profound reduction in disease activity score. But after few months of withdrawal of DMARD, patients experienced flareup of disease necessitating aggressive treatment. Among the three DMARDS (HCQ/MTX/LEF), HCQ was found to be safe and effective in RA in long term use. LEF was highly effective but with greater withdrawal due to adverse reactions. Patients belonging to lower economic class managed the disease with NSAIDS, resulting in frequent flareups and inadequate treatment. Failure to use DMARD caused deformities of joints. Early initiation of DMARD was very effective to achieve clinical remission. TBARS levels indicative of lipid peroxidation were very high in RA patients and antioxidant levels were very low in RA patients. Ayurvedic treatment resulted in greater reduction of TBARS and greater increase in antioxidants than Allopathic treatment. Majority of patients were positive for EBV antibodies. TNF-and#945;. expression was nil/low in RA patients of Ayurvedic treatment.