Harpagophytum procumbens Clinical trials

J Pharm Pharmacol. 2014 Aug 31. doi: 10.1111/jphp.12242. [Epub ahead of print]

Alteration of anti-inflammatory activity of Harpagophytum

procumbens (devil's claw) extract after external metabolic
activation with S9 mix.
Hostanska K1, Melzer J, Rostock M, Suter A, Saller R.
Author information
Abstract
Extracts of the tubers of Harpagophytum procumbens ( OBJECTIVES devil's claw: DC dose-dependently suppressed the release of TNF-, IL-6 and
IL-8 in LPS-stimulated monocytic THP-1 cells at non-cytotoxic concentrations (50-250g/ml). The metabolic activation of the DC extract by S9 mix did
not alternate its cytotoxicity and did not diminish its inhibitory effect. This effect was improved in the case of TNF- inhibition as reflected by their EC50
values of 1168.2g/ml and 493.5g/ml for DC and DCm (P : A screening experiment with a panel of 12 inflammatory cytokines identified three as
suitable for the study: tumour necrosis factor- (TNF-), interleukin (IL) IL-6 and IL-8. They were determined using enzyme-linked immunosorbent
assays in lipopolysaccharide (LPS)-stimulated monocytic THP-1 cells, which were treated with rat liver S9 mix metabolically activated DC extract
(DCm). For the cytotoxity experiments, a WST-1 assay was used. KEY FINDINGS , DC) inhibit different proinflammatory mediators important in the
pathophysiology of osteoarthritis. Many plant-derived preparations interfere with cytochrome P450 liver enzymes, which influence their different
biological activities. Therefore, the present study was designed to investigate the influence of an external metabolic activation of a DC extract on the
cytotoxicity and the release of proinflammatory cytokines. METHODS<: Cytokines inhibitory activity of DC was not affected after its external metabolic
activation. However, the amount of harpagoside and caffeic acid derivates was decreased. Other components of the extract might have contributed to
its anti-inflammatory effect. 0.01). CONCLUSIONS

Phytomedicine. 2009 Dec;16(12):1095-100. doi: 10.1016/j.phymed.2009.05.001. Epub 2009 Jul 3.

Effects of Devil's Claw (Harpagophytum procumbens) on the

multidrug transporter ABCB1/P-glycoprotein.
Romiti N1, Tramonti G, Corti A, Chieli E.
Author information
Abstract
Devil's Claw (Harpagophytum procumbens) a plant native to Southern Africa, has historically been used in traditional medicine to treat a wide range of
diseases and currently is widely employed as anti-inflammatory and pain-relieving natural remedy in Europe and other parts of the world.
AIM OF THE STUDY:
Little is known about possible herb-drug interactions arising from effects of Devil's Claw on the major drug metabolizing enzymes or transporters. This
study evaluated in vitro the effects of Devil's Claw on the multidrug transporter ABCB1/P-glycoprotein.
MATERIALS AND METHODS:
The effects of three commercially available Devil's Claw preparations and that of pure harpagoside were studied in the human kidney (HK-2) proximal
tubule cell line, constitutively expressing ABCB1/P-glycoprotein (P-gp). Pgp activity and expression were tested by the calcein-AM test and by Western
blotting, respectively.
RESULTS:
Commercial preparations inhibited P-gp activity, even if to a different extent, while pure harpagoside was almost ineffective. In cells cultured for three
days in the presence of Devil's Claw preparations or pure harpagoside, a dose-dependent P-gp upregulation was found.
CONCLUSIONS:
Our results demonstrate for the first time that Devil's Claw may interact with the multidrug transporter ABCB1/P-gp, the effect not appearing strictly
related to the harpagoside relative content. Modulation of both P-gp activity and P-gp expression by Devil's Claw raise the possibility of herb-drug
interactions, to be further explored in depth.

J Nat Med. 2010 Apr;64(2):219-22. doi: 10.1007/s11418-010-0395-8. Epub 2010 Feb 23.

Inhibitory effects of devil's claw (secondary root of

Harpagophytum procumbens) extract and harpagoside on
cytokine production in mouse macrophages.

Inaba K1, Murata K, Naruto S, Matsuda H.

Author information
Abstract
Successive oral administration (50 mg/kg) of a 50% ethanolic extract (HP-ext) of devil's claw, the secondary root of Harpagophytum procumbens,
showed a significant anti-inflammatory effect in the rat adjuvant-induced chronic arthritis model. HP-ext dose-dependently suppressed the
lipopolysaccharide (LPS)-induced production of inflammatory cytokines [interleukin-1beta (IL-1beta), interleukin-6 (IL-6), and tumor necrosis factoralpha (TNF-alpha)] in mouse macrophage cells (RAW 264.7). Harpagoside, a major iridoid glycoside present in devil's claw, was found to be one of the
active agents in HP-ext and inhibited the production of IL-1beta, IL-6, and TNF-alpha by RAW 264.7.

J Ethnopharmacol. 2012 Oct 11;143(3):755-71. doi: 10.1016/j.jep.2012.08.013. Epub 2012 Aug 21.

Devil's Claw-a review of the ethnobotany, phytochemistry and

biological activity of Harpagophytum procumbens.
Mncwangi N1, Chen W, Vermaak I, Viljoen AM, Gericke N.
Author information
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE:
Harpagophytum procumbens subps. procumbens (Burch.) DC. ex Meisn. (Pedaliaceae) is an important traditional medicine growing in the Kalahari
region of southern Africa where it is consumed as a general health tonic and for treating diverse ailments including arthritis, pain, fever, ulcers and
boils.
AIM OF THE REVIEW:
To provide a comprehensive overview of the ethnobotany, phytochemistry and biological activity of H. procumbens and possibly make
recommendations for further research.
MATERIALS AND METHODS:
Peer-reviewed articles on H. procumbens were acquired on Scopus, ScienceDirect and SciFinder, there was no specific timeline set for the search. A
focus group discussion was held with different communities in Botswana to further understand ethnobotanical uses of the plant.
RESULTS:
Harpogophytum procumbens is used for a wide variety of health conditions in the form of infusions, decoctions, tinctures, powders and extracts. In
addition to the common local use for arthritis and pain, other ethnomedicinal uses include dyspepsia, fever, blood diseases, urinary tract infections,
postpartum pain, sprains, sores, ulcers and boils. Scientific studies revealed that H. procumbens exhibits analgesic, anti-oxidant, anti-diabetic, antiepileptic, antimicrobial and antimalarial activities amongst others. Iridoid glycosides and phenylpropanoid glycosides have been the focus of
phytochemical investigations as the biological activity has been ascribed to the iridoid glycosides (such as harpagoside and harpagide), which are
common in nature and are known to possess anti-inflammatory activity. In addition, it has been shown that the hydrolysed products of harpagoside and
harpagide have more pronounced anti-inflammatory activity when compared to the unhydrolysed compounds. Harpagophytum zeyheri is a close
taxonomic ally of H. procumbens but H. procumbens is the favoured species of commerce, and contains higher levels of the pharmacologically active
constituents. The two are used interchangeably and H. procumbens raw material is often intentionally adulterated with H. zeyheri and this may impact
on the efficacy of inadequately controlled health products. The main exporter of this highly commercialised plant is Namibia. In 2009 alone,
Harpagophytum exports were worth approximately 1.06 million. The high demand for health products based on this plant has led to over-harvesting,
raising concerns about sustainability. Although only the secondary tubers are utilised commercially, the whole plant is often destroyed during
harvesting.
CONCLUSIONS:
Harpagophytum procumbens is used to treat a wide range of ailments. Some of the ethnobotanical claims have been confirmed through in vitro
studies, however, when the constituents deemed to be the biologically active compounds were isolated the efficacy was lower than that of the whole
extract. This necessitates the use of a different approach where all the metabolites are considered using a robust method such as spectroscopy; the
phytochemical data can then be superimposed on the biological activity. Furthermore, there is a need to develop rapid and efficient quality control
methods for both raw materials and products because the orthodox methods in current use are time-consuming and labour intensive.
Copyright 2012 Elsevier Ireland Ltd. All rights reserved.

J Pharm Pharmacol. 2011 Mar;63(3):429-38. doi: 10.1111/j.2042-7158.2010.01235.x. Epub 2011 Feb 8.

The interaction potential of herbal medicinal products: a

luminescence-based screening platform assessing effects on
cytochrome P450 and its use with devil's claw (Harpagophyti
radix) preparations.
Modarai M1, Suter A, Kortenkamp A, Heinrich M.
Author information
Abstract

OBJECTIVES:
Potential interactions between herbal medicinal products and the cytochrome (CYP) P450 system are an important safety concern. We set out to
develop a screening panel for assessing such interactions and use it to evaluate the interaction potential of devil's claw.
METHODS:
The panel consisted of luminescence-based inhibition assays for CYP1A2, 2C9, 2C19, 2D6 and 3A4, and a reporter gene (luciferase) assay for
pregnane X receptor (PXR) activation and CYP3A4 induction. Caftaric acid and chlorogenic acid, two compounds with strong fluorescence quenching
properties, were used to demonstrate the assay's resistance to interference. We tested 10 commercial devil's claw preparations as well as harpagoside
and harpagide, two important constituents of devil's claw.
KEY FINDINGS:
Five preparations were found to weakly inhibit CYP3A4 (IC50 124.2-327.6 g/ml) and five were found to weakly activate PXR (EC50 10.21-169.3
g/ml). Harpagoside and harpagide did not inhibit CYP3A4. In agreement with published data, bergamottin, a natural product known to interact with
CYP3A4, was shown to inhibit CYP3A4 with an IC50 of 13.63 m and activate PXR with an EC50 of 6.7 m.
CONCLUSIONS:
Devil's claw preparations are unlikely to have a clinically relevant effect on CYP function. The assay panel proved effective in
screening devil's claw preparations, demonstrating its suitability for use with plant extracts. It showed superior sensitivity and resistance to interference.

J Altern Complement Med. 2006 Dec;12(10):981-93.

Devil's Claw (Harpagophytum procumbens) as a treatment for

osteoarthritis: a review of efficacy and safety.
Brien S1, Lewith GT, McGregor G.
Author information
Abstract
BACKGROUND:
Osteoarthritis (OA) is a highly prevalent musculoskeletal disorder. Conventional treatment (i.e., the use of nonsteroidal anti-inflammatory drugsNSAIDs) is associated with well-documented adverse effects. Devil's Claw (Harpagophytum procumbens) a traditional South African herbal remedy
used for rheumatic conditions, may be a safer treatment option. To date, 14 clinical trials have assessed its efficacy/ effectiveness in OA.
AIM:
To address the two main questions of importance to clinicians: (1) Does Devil's Claw work for the treatment of OA, and (2) Is it safe?
METHODS:
A review of the literature on Devil's Claw and OA from 1966 to 2006 was performed using multiple search databases, monographs, and citation
tracking. Relevant trials in all languages were identified and included. Both internal validity (i.e., adequacy of the dosage and period of treatment for
this condition, reporting of randomization, rates of dropout, blinding, and statistical analysis) and external validity (i.e., inclusion/ exclusion criteria,
baseline characteristics of the study populations, trial setting, and the appropriateness of the outcome measures of the trials) were assessed.
RESULTS:
Fourteen studies were identified: eight observational studies; 2 comparator trials (1 open, the other randomized to assess clinical effectiveness); and 4
double-blinded, placebo-controlled, randomized controlled trials to assess efficacy. Many of the published trials lacked certain important
methodological quality criteria. However, the data from the higher quality studies suggest that Devil's Claw appeared effective in the reduction of the
main clinical symptom of pain. The assessment of safety is limited by the small populations generally evaluated in the clinical studies. From the current
data, Devil's Claw appears to be associated with minor risk (relative to NSAIDs), but further long-term assessment is required.
CONCLUSIONS:
The methodological quality of the existing clinical trials is generally poor, and although they provide some support, there are a considerable number of
methodologic caveats that make further clinical investigations warranted. The clinical evidence to date cannot provide a definitive answer to the two
questions posed: (1) Does it work? And (2) is it safe? A definitive high-quality trial that addresses the necessary methodologic improvements noted is
needed to answer these important clinical questions.

Altern Ther Health Med. 2014 Winter;20 Suppl 1:32-7.

A complex of three natural anti-inflammatory agents provides

relief of osteoarthritis pain.
Conrozier T, Mathieu P, Bonjean M, Marc JF, Renevier JL, Balblanc JC.
Abstract
BACKGROUND:
Devil's claw (Harpagophytum procumbens), turmeric (Curcuma longa), and bromelain are nutraceuticals that have demonstrated anti-inflammatory and
analgesic properties and may be potential solutions in the treatment of acute or chronic joint pain. Their analgesic effect, however, is generally
considered mild to moderate, and the relevance of their clinical use remains subject to discussion.

OBJECTIVES:
The aim of the study was to evaluate the clinical relevance of the efficacy of a marketed complex of 3 plant extracts-H procumbens, C longa, and
bromelain (AINAT, 650 mg)-in the treatment of degenerative joint pain.
METHODS:
A multicenter, observational, prospective, open-label survey was conducted in 8 rheumatology centers. The study included 2 groups, 1 group with
participants suffering from chronic osteoarthritis (OA) pain and 1 group suffering from acute OA pain.
SETTING:
The research team carried out the study under daily practice conditions.
PARTICIPANTS:
A total of 42 patients (36 women; mean age = 67 y) suffering from acute or chronic, degenerative spine or joint pain participated.
INTERVENTION:
Two 650-mg capsules of AINAT were administered 3 /d to patients with acute pain and 2 /d to patients with chronic pain.
OUTCOME MEASURES:
At baseline, and during a follow-up visit at 15 d for the acute pain group and 60 d for the chronic pain group, the research team obtained each
participant's global assessment (PGA) and each rheumatologist's global assessment (RGA), as well as each participant's pain score, using for each of
them a 100-mm visual analogue scale (VAS). The clinical relevance of the efficacy was evaluated by comparing the outcome measures at endpoint to
the values defining the patient acceptable symptom state (PASS) and by comparing the variations (in mm and %) between baseline and endpoint to
those defining the minimal clinically important improvement (MCII). Tolerance was also assessed by collecting adverse events at each visit and by
using a 4-point scale (very good to bad) at the endpoint.
RESULTS:
At baseline, the VAS pain score (standard deviation) was 69.1 mm (15.4) and 68.0 mm (18.2) for patients with acute and chronic pain, respectively. At
the endpoint, the scores decreased to 42.1 mm (21.1) and 37.8 mm (25.9), respectively. This reduction of pain, as a percentage as well as an absolute
value, corresponds to the required definition of MCII, particularly in patients with chronic joint pain. At the endpoint, most of the patients in both groups
reached the level of pain defined as the PASS. No withdrawals occurred due to treatment side effects.
CONCLUSION:
The improvement of joint pain was clinically relevant in patients treated with AINAT for both acute and chronic OA pain. Considering its excellent
tolerance profile, the tested complex of 3 plant extracts with antiinflammatory properties may be a valuable and safe alternative to NSAIDs in patients
suffering from degenerative joint diseases.

Ther Adv Musculoskelet Dis. 2012 Jun;4(3):181-207. doi: 10.1177/1759720X11436238.

Current nutraceuticals in the management of osteoarthritis: a

review.
Akhtar N1, Haqqi TM.
Author information
Abstract
Osteoarthritis (OA) is a progressive degenerative joint disease that has a major impact on joint function and quality of life. Nutraceuticals and dietary
supplements derived from herbs have long been used in traditional medicine and there is considerable evidence that nutraceuticals may play an
important role in inflammation and joint destruction in OA. We review the biological effects of some medicinal fruits and herbs - pomegranate, green
tea, cat's claw, devil's claw, ginger, Indian olibaum, turmeric and ananas - in an attempt to understand the pivotal molecular targets involved in
inflammation and the joint destruction process and to summarize their toxicities and efficacy for OA management. So far there is insufficient reliable
evidence on the effectiveness of ginger, turmeric and ananas. Pomegranate and green tea only have preclinical evidence of efficacy due to the lack of
clinical data. In vivo and clinical studies are required to understand their targets and efficacy in OA. Limited in vitro and in vivo evidence is available for
cat's claw and Indian olibaum. More extensive studies are required before long-term controlled trials of whole cat's claw and Indian olibaum extracts, or
isolated active compounds, are carried out in patients with OA to determine their long-term efficacy and safety. Devil's claw has not been rigorously
tested to determine its antiarthritic potential in in vitro and in vivo models. There is strong clinical evidence of the effectiveness of devil's claw in pain
reduction. However, high-quality clinical trials are needed to determine its effectiveness. No serious side effects have been reported for any fruits and
herbs. Overall, these studies identify and support the use of nutraceuticals to provide symptomatic relief to patients with OA and to be used as adjunct
therapy for OA management. More high-quality trials are needed to provide definitive answers to questions related to their efficacy and safety for OA
prevention and/or treatment.

Phytother Res. 2012 Jun;26(6):806-11. doi: 10.1002/ptr.3636. Epub 2011 Nov 10.

Molecular targets of the antiinflammatory Harpagophytum

procumbens (devil's claw): inhibition of TNF and COX-2 gene
expression by preventing activation of AP-1.
Fiebich BL1, Muoz E, Rose T, Weiss G, McGregor GP.

Author information
Abstract
Harpagophytum procumbens (Hp) is often used in the supportive treatment of inflammatory and degenerative diseases of the skeletal system.
Although the clinical efficacy in osteoarthritis has been demonstrated in clinical trials, the molecular target(s) of Hp are unclear. This study quantified
the effects of the ethanol Hp extract (60% v/v ethanol, sole active ingredient of Pascoe-Agil), on the expression and release of the major proinflammatory mediators in LPS-stimulated human monocytes and the intracellular signalling pathways involved in inflammation. The Hp extract dosedependently inhibited the release of TNF as well as that of interleukin (IL)-6, IL-1 and prostaglandin E (PGE). The Hp prevented TNF and IL-6
mRNA expression in human monocytes and cyclooxygenase-2 (COX-2) in RAW 264.7 cells. Furthermore, the Hp extract inhibited LPS-stimulated AP1-mediated gene transcription activity and binding to the AP-1 response elements. The extract had no effect on the LPS-induced binding of nuclear
factor-B in RAW 264.7 cells, on LPS-induced degradation of IB or on LPS-induced activation of mitogen-activated protein kinases (MAPK),
p38MAPK and JNK in human monocytes. The data indicate that a standardized ethanol Hp extract inhibits induction of pro-inflammatory gene
expression, possibly by blocking the AP-1 pathway. This is novel evidence of a possible mechanism of action of this antiinflammatory drug.

Altern Med Rev. 2011 Sep;16(3):228-38.

The use of glucosamine, devil's claw (Harpagophytum

procumbens), and acupuncture as complementary and
alternative treatments for osteoarthritis.
Sanders M1, Grundmann O.
Author information
Abstract
Osteoarthritis is one of the most common chronic inflammatory conditions seen in the general population. Current pharmacological treatments focus on
reduction of pain and increased mobility to improve overall quality of life. However, the relief afforded by current standard care is often insufficient and
can be associated with significant side effects. Many patients, therefore, seek the option of non-standard therapies, such as nutritional and herbal
supplements, acupuncture, and exercise regimens. Glucosamine, Harpagophytum procumbens, and acupuncture are among the most commonly used
complementary and alternative medicine approaches utilized by patients suffering from osteoarthritis. Their clinical relevance, safety, and potential
mechanisms of action are discussed in this review.

Phytother Res. 2009 Nov;23(11):1497-515. doi: 10.1002/ptr.3007.

Evidence of effectiveness of herbal medicinal products in the

treatment of arthritis. Part I: Osteoarthritis.
Cameron M1, Gagnier JJ, Little CV, Parsons TJ, Blmle A, Chrubasik S.
Author information
Abstract
Herbal medicinal products (HMPs) are used in a variety of oral and topical forms for the treatment of osteoarthritis. The aim of this study was to update
a previous systematic review published in 2000. We searched electronic databases (MEDLINE, EMBASE, CISCOM, AMED, CINAHL, Cochrane
registers) to June 2007, unrestricted by date or language, and included randomized controlled trials that compared HMPs with inert (placebo) or active
controls in patients with osteoarthritis. Five reviewers contributed to data extraction. Disagreements were discussed and resolved by consensus with
reference to Cochrane guidelines and advice from the Cochrane Collaboration.Thirty-five studies (30 studies identified for this review update, and 5
studies included in the original review) evaluating the effectiveness of 22 HMPs were included. However, due to differing HMPs, interventions,
comparators, and outcome measures, meta-analysis was restricted to data from studies of three HMPs: topical capsaicin, avocado-soybean
unsaponifiables, and the Chinese herbal mixture SKI306X showed benefit in the alleviation of osteoarthritic pain.Several studies investigating products
from devil's claw, and a powder from rose hip and seed, reported favorable effects on osteoarthritic pain, whereas two studies of a willow bark extract
returned disparate results. Three studies of Phytodolor N(R) were of limited use because doses and measures were inconsistent among trials. The
remaining single studies for each HMP provided moderate evidence of effectiveness. No serious side effects were reported with any herbal
intervention.Despite some evidence, the effectiveness of none of the HMPs is proven beyond doubt. The obvious potential benefits of HMPs in the
treatment of osteoarthritis are reduced reliance on synthetic medications with the associated risks of harmful adverse events, but further clinical trials
are necessary before HMPs can be adopted in osteoarthritis treatment guidelines.

Am Fam Physician. 2008 Jan 15;77(2):177-84.

Dietary supplements for osteoarthritis.

Gregory PJ1, Sperry M, Wilson AF.
Author information
Abstract
A large number of dietary supplements are promoted to patients with osteoarthritis and as many as one third of those patients have used a supplement
to treat their condition. Glucosamine-containing supplements are among the most commonly used products for osteoarthritis. Although the evidence is
not entirely consistent, most research suggests that glucosamine sulfate can improve symptoms of pain related to osteoarthritis, as well as slow
disease progression in patients with osteoarthritis of the knee. Chondroitin sulfate also appears to reduce osteoarthritis symptoms and is often
combined with glucosamine, but there is no reliable evidence that the combination is more effective than either agent alone. S-adenosylmethionine

may reduce pain but high costs and product quality issues limit its use. Several other supplements are promoted for treatingosteoarthritis, such as
methylsulfonylmethane, Harpagophytum procumbens (devil's claw), Curcuma longa (turmeric), and Zingiber officinale (ginger), but there is insufficient
reliable evidence regarding long-term safety or effectiveness.

Phytother Res. 2007 Dec;21(12):1228-33.

Effectiveness and safety of Devil's Claw tablets in patients with

general rheumatic disorders.
Warnock M1, McBean D, Suter A, Tan J, Whittaker P.
Author information
Abstract
Arthritis and other rheumatic conditions (AORC) are the leading cause of disability, are associated with poor quality of life and incur considerable direct
and indirect costs. It is considered that the instance of AORC will continue to increase. To assess the effectiveness, safety and tolerability of
Harpagophytum (Bioforce) in the treatment of AORC, a single group open study of 8 weeks duration (259 patients) was performed in the United
Kingdom. Effectiveness was assessed by numeric rating scales, the Western Ontario and McMasters Universities Osteoarthritis (WOMAC) Index and
the Algofunctional Hand Osteoarthritis Index. Tolerance was measured by a numeric rating scale and safety by self-reporting, blood analysis and liver
function tests. Quality of life was measured by SF-12 questionnaire. There were statistically significant (p < 0.0001) improvements in patient
assessment of global pain, stiffness and function. There were also statistically significant reductions in mean pain scores for hand, wrist, elbow,
shoulder, hip, knee and back pain. Quality of life measurements (SF-12) were significantly increased from baseline and 60% patients either reduced or
stopped concomitant pain medication. Harpagophytum is an effective and well-tolerated serious treatment option for mild to moderate degenerative
rheumatic disorders providing improved quality of life measure.

Holist Nurs Pract. 2007 Jul-Aug;21(4):203-7.

A review of the efficacy and safety of devil's claw for pain

associated with degenerative musculoskeletal diseases,
rheumatoid, and osteoarthritis.
Denner SS.
Author information
Abstract
Harpagophytum procumbens, known as devil's claw, has been used traditionally for the treatment of pain, fevers, and dyspepsia. Recently, it has
become popular for the treatment of rheumatoid and osteoarthritis. Studies have yet to establish a clear mechanism of action; however, current
research is focusing on pro-inflammatory mediators as well as on potential antioxidant characteristics.

J Herb Pharmacother. 2006;6(1):89-126.

Devil's Claw (Harpagophytum procumbens DC): an evidencebased systematic review by the Natural Standard Research
Collaboration.
Brendler T1, Gruenwald J, Ulbricht C, Basch E; Natural Standard Research Collaboration.
Author information
Abstract
An evidence-based systematic review including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history,
pharmacology, kinetics/dynamics, interaction, adverse effects, toxicology, and dosing.

Clin J Pain. 2004 Jan-Feb;20(1):13-8.

Selected CAM therapies for arthritis-related pain: the evidence

from systematic reviews.
Soeken KL.
Author information
Abstract
OBJECTIVES:
The purpose is to examine what is known about the efficacy of selected complementary and alternative medicine (CAM) therapies for pain from arthritis
and related conditions based on systematic reviews and meta-analyses.

METHODS:
Results specifically related to pain were retrieved from review articles of acupuncture, homeopathy, herbal remedies, and selected nutritional
supplements.
RESULTS:
Evidence exists to support the efficacy of reducing pain from osteoarthritis (OA) for acupuncture; devil's claw, avocado/soybean unsaponifiables,
Phytodolor and capsaicin; and chondroitin, glucosamine, and SAMe. Strong support exists for gamma linolenic acid (GLA) for pain of rheumatoid
arthritis (RA).
CONCLUSIONS:
Despite support for some of the most popular CAM therapies for pain from arthritis-related conditions, additional high quality research is needed for
other therapies, especially for herbals and homeopathy.

Wien Med Wochenschr. 2002;152(15-16):389-92.

[Degenerative diseases of the musculoskeletal system--overview

of current clinical studies of Devil's Claw(Harpagophyti radix)].
[Article in German]

Wegener T.
Author information
Abstract
Herbal medicinal products with secondary tubers of Devil's Claw (Harpagophyti radix) are successfully used in degenerative rheumatism. The interest
in this herbal drug is documented by many controlled and uncontrolled clinical studies in the last few years. Efficacy was tested in patients with
degenerative rheumatism or low back pain. There was shown an improvement of motility and a reduction of pain sensation and a good tolerability
following an administration even for only few weeks.