Phytotherapy as an adjunct to the treatment of rheumatoid arthritis - a systematic review of clinical trials

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#arthritis-rheumatoid #humans #phytotherapy #tripterygium #curcuma

Phytotherapy as an adjunct to the treatment of rheumatoid arthritis - a systematic review of clinical trials

Piekarz et al., 2025 | Phytomedicine | Systematic Review

Citation

Piekarz Julia, Picheta Natalia, ... Gil-Kulik Paulina. Phytotherapy as an adjunct to the treatment of rheumatoid arthritis - a systematic review of clinical trials. Phytomedicine. 2025-Nov-25;148:157285. doi:10.1016/j.phymed.2025.157285

Abstract

BACKGROUND: Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disease whose incidence is on an upward trend. The condition leads to progressive joint destruction, manifested by symptoms such as morning stiffness, pain, and swelling, all of which significantly reduce patients' quality of life. Standard therapeutic approaches, despite significant progress, are associated with side effects and do not always achieve sustained remission of the disease. For this reason, there is growing interest in complementary methods, including phytotherapy. Numerous plant raw materials exhibit anti-inflammatory and immunomodulatory properties, making them potentially valuable adjunctive components of RA treatment. PURPOSE: The purpose of this systematic review is to evaluate the effects of constituents contained in plants: Curcuma longa, Zingiber officinale, Tripterygium wilfordii and Salvia miltiorrhiza on clinical symptoms, laboratory parameters and disease activity indicators in patients with rheumatoid arthritis. METHODS: This systematic review was based on a comprehensive analysis of the literature from PubMed, Scopus and SpringerLink databases, covering publications from 2014 to 2025. Article selection was performed according to PRISMA guidelines, and risk of bias was assessed according to the Cochrane Risk of Bias tool for randomized trials (RoB 2.0). Fourteen randomized controlled trials were included in the final analysis to ensure valid and reliable data. RESULTS: Phytotherapy is a rapidly evolving field that is gaining increasing relevance in modern medicine. Many herbs have potential applications in the supportive therapy of many diseases, thanks to their multidirectional pharmacological properties. Analysis of the available data indicates positive effects of Curcuma longa, Zingiber officinale, Tripterygium wilfordii and Salvia miltiorrhiza in supportive therapy for RA patients. The study showed that better improvements in disease activity indices were obtained in patients receiving herbal-assisted therapy than patients treated with standard therapy alone. Most trials reported improvements in disease activity indices compared to control; however, in some studies - including the RCT by Javadi et al. - the between-group difference did not reach statistical significance. CONCLUSION: Curcuma longa, Zingiber officinale, Tripterygium wilfordii and Salvia miltiorrhiza show therapeutic potential as adjunctive agents in RA therapy. They may provide many benefits, such as reducing side effects of traditional therapies, improving patients' functioning and quality of life. Despite promising research results, it is essential to develop and expand clinical trials related to phytotherapy in order to systematize knowledge regarding the safety and efficacy of phytotherapy in RA patients.

Key Findings

Phytotherapy is a rapidly evolving field that is gaining increasing relevance in modern medicine. Many herbs have potential applications in the supportive therapy of many diseases, thanks to their multidirectional pharmacological properties. Analysis of the available data indicates positive effects of Curcuma longa, Zingiber officinale, Tripterygium wilfordii and Salvia miltiorrhiza in supportive therapy for RA patients. The study showed that better improvements in disease activity indices were

Outcomes Measured

  • inflammatory markers

Population

Field Value
Population rheumatoid arthritis
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Arthritis, Rheumatoid
  • Humans
  • Phytotherapy
  • Tripterygium
  • Curcuma
  • Zingiber officinale
  • Plant Extracts
  • Salvia miltiorrhiza
  • Randomized Controlled Trials as Topic
  • Quality of Life

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article
  • Vertical: ginger

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09