A Chinese herb sometimes referred to as ‘take 7 steps and die’ has been found to be as good as methotrexate for treating active rheumatoid arthritis, a potential trigger for neck pain. Also known as thunder god vine and lei gong teng, Tripterygium wilfordii Hook f (or TwHF for short), has been used for centuries in Traditional Chinese Medicine (TCM) to ease the symptoms of joint pain and inflammation. However, home-brewed concoctions of this herb can prove deadly, leading British medical authorities to issue a safety warning over its use in recent years.
In this latest study, TwHF alone and TwHF combined with methotrexate were compared to methotrexate alone to determine the possible benefits of the herb on arthritis pain and other symptoms of the rheumatic disease. The extract used was given at a dose of 20mg three times a day either alone or alongside 12.5mg of methotrexate once a week. This dose of methotrexate is lower than the typical dose used in the US but is standard in many parts of Asia. The TwHF was all from the same batch, manufactured by Zhejiang DND pharmaceutical Company, and standardised to contain triptolide (C20H24O5) at 1.2 µg/10 mg, and wilforlide (C30H46O3).
Low Cost Herbal Remedy for RA
Some 207 patients were recruited for the study, which took place across 9 clinics in China where patients were being treated for RA. Methotrexate is a standard treatment for this joint condition which results from autoimmune dysfunction where the body attacks itself. The use of TwHF for RA is common in China, with one hospital treating around half of patients with the herb, mostly in combination with methotrexate. This helps to keep costs low while improving the efficacy of treatment.
This latest study was published in the Annals of the Rheumatic Diseases and detailed the research carried out by Xuan Zhang, MD., professor of medicine in the Department of Rheumatology at Peking Union Medical College Hospital, Beijing, China.
The study used the American College of Rheumatology Criteria to monitor the effects of the treatments, focusing on the percentage of patients who achieved at least a 50% improvement in symptoms, referred to as ACR50. This is defined as measured improvement in tender or swollen joint counts and in at least three of the following:
- Acute phase reactant (such as sedimentation rate)
- Patient assessment
- Physician assessment
- Pain scale
- Disability/functional questionnaire
Benefits of Thunder God Vine
Patients treated with methotrexate alone had an ACR50 response rate of 46.4% by the 24th week of the study. Those receiving TwHF alone had an ACR50 response rate of 55.1%, while those receiving both the herb and the medication had a 76.8% response rate.
These positive, significant results support the use of thunder god vine for rheumatoid arthritis, but only in a safe and controlled way. This is because the plant is largely toxic and, if not prepared correctly, it can cause severe adverse effects and even death. In this study however, the care taken in procuring a safely produced extract led to no more adverse effects in the groups using TwHF than in the methotrexate group.
Side Effects of Thunder God Vine
Potential adverse effects from thunder god vine include fatal kidney failure, liver failure, reversible ovarian failure, cardiogenic shock and death, and fatal hypovolvemic shock (a condition where the volume of blood in the body is too low for survival). As such, women of reproductive age are usually advised not to use this herb unless they are uninterested in conceiving, with the herb mostly prescribed for post-menopausal women due to its effects on hormones.
Extracts available in the US have been tested in the laboratory and found to cause toxicity to bone marrow cells. Anyone considering the use of thunder god vine for rheumatoid arthritis should be carefully monitored by their physician so as to detect any potential toxic effects quickly. This herb can cause aplastic anemia through its effects on the stem cells in bone marrow that build new blood cells.
Other natural treatments for neck pain from rheumatoid arthritis are available, including topical pain-relieving gels.
Qian-wen Lv, Wen Zhang, Qun Shi1, et al. (2014). Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis (TRIFRA): a randomised, controlled clinical trial, Ann Rheum Dis doi:10.1136/annrheumdis-2013-204807.