Oral herbal medicines marketed in Brazil for the treatment of osteoarthritis: A systematic review and meta-analysis
Mariana Del Grossi Moura
Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo, Brazil
Search for more papers by this authorLuciane Cruz Lopes
Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo, Brazil
Search for more papers by this authorMaique Weber Biavatti
Pharmaceutical Department, Federal University of Florianopolis, Florianopolis, Santa Catarina, Brazil
Search for more papers by this authorSean Alexander Kennedy
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Search for more papers by this authorMaria Carolina de Oliveira e Silva
Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo, Brazil
Search for more papers by this authorMarcus Tolentino Silva
Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo, Brazil
Search for more papers by this authorCorresponding Author
Cristiane de Cássia Bergamaschi
Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo, Brazil
Correspondence to: Cristiane de Cássia Bergamaschi, Universidade de Sorocaba – UNISO, Rodovia Raposo Tavares, Km 92.5, 18023-000, Sorocaba, SP, Brazil.
E-mail: [email protected]
Search for more papers by this authorMariana Del Grossi Moura
Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo, Brazil
Search for more papers by this authorLuciane Cruz Lopes
Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo, Brazil
Search for more papers by this authorMaique Weber Biavatti
Pharmaceutical Department, Federal University of Florianopolis, Florianopolis, Santa Catarina, Brazil
Search for more papers by this authorSean Alexander Kennedy
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Search for more papers by this authorMaria Carolina de Oliveira e Silva
Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo, Brazil
Search for more papers by this authorMarcus Tolentino Silva
Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo, Brazil
Search for more papers by this authorCorresponding Author
Cristiane de Cássia Bergamaschi
Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo, Brazil
Correspondence to: Cristiane de Cássia Bergamaschi, Universidade de Sorocaba – UNISO, Rodovia Raposo Tavares, Km 92.5, 18023-000, Sorocaba, SP, Brazil.
E-mail: [email protected]
Search for more papers by this authorAbstract
Herbal medications are commonly used to manage symptoms associated with osteoarthritis (OA). This systematic review evaluated the effectiveness and safety of oral medications used in Brazil for the treatment of OA. Randomized clinical trials involving adults with OA treated by a herbal medicine or a control group were eligible. The primary outcomes measured were pain, physical function, swelling, stiffness and quality of life; and the secondary outcomes were adverse events, activity limitations and treatment satisfaction. Sixteen studies were included (n = 1,741 patients) in the systematic review and nine studies in the meta-analysis, representing 6 of the 13 herbal medicines studied: Boswellia serrata (n = 2), Curcuma longa (n = 3), Harpagophytum procumbens (n = 1), Salix daphnoides (n = 3), Uncaria guianensis (n = 2) and Zingiber officinale (n = 5). B. serrata was more effective than both placebo and valdecoxib for improvement of pain and physical function. No difference was observed for H. procumbens, C. longa and U. guianensis compared with control. Z. officinale showed improvement of pain over placebo. The evidence was insufficient to support the effective and safe use of these herbal medicines, because the quality of evidence of studies was low. This study guides managers of the Brazilian public health system and prescribers in decision-making regarding the use of these herbal medicines for OA. Copyright © 2017 John Wiley & Sons, Ltd.
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