Phytotherapy for osteoarthritis

Summary

Background: In order to present recent findings on the effectiveness and safety of phytotherapy for treatment of osteoarthritis (OA) we summarized the two latest Cochrane reviews (Cameron & Chrubasik, 2013; Cameron & Chrubasik, 2014). One of them included oral and the other topical herbal treatment options as a treatment for OA.

Methods: We conducted a thorough evaluation of the Cochrane reviews. We assessed methodological quality of the reviews and extracted evidence.

Results: Meta-analyses found evidence for effects of the oral herbal products Boswellia serrata and only partially for avocado-soybean unsaponifiable (ASU). However, they included only a small number of primary studies. The systematic review on topical herbal treatments included fewer trials and did not include a meta-analysis.

Discussion: Based on the qualitative syn­thesis Boswellia serrata can be applied in the treatment of OA. It is not clear if ASU can be recommended. No valid recommendation can be given for or against other herbal therapies due to a lack of randomized ­clinical trials in the field.

Zusammenfassung

Phytotherapie bei Arthrose: Evidenz zweier Cochrane-Reviews

Hintergrund: Um aktuelle Erkenntnisse über Wirksamkeit und Sicherheit von phytotherapeutischen Präparaten bei der Behandlung von Osteoarthritis (OA) zu erlangen, wurden die beiden neuesten Cochrane-Reviews (Cameron & Chrubasik, 2013; ­Cameron & Chrubasik, 2014) zusammengefasst. Ein Review befasste sich mit oralen und der andere mit topisch-pflanzlichen Behandlungsmöglichkeiten bei OA.

Methodik: Es wurde eine gründliche Bewertung der beiden Cochrane-Reviews durchgeführt. Wir beurteilten die methodische Qualität der Bewertungen und leiteten ­daraus Aussagen zur Evidenz ab.

Ergebnisse: Die Metaanalysen offenbarten Nachweise für die Wirkung der oralen ­Boswellia-serrata-Produkte sowie der teilweisen Wirksamkeit der Avocado-Soja (ASU)-Präparate. Die Primärstudien enthielten jedoch nur eine kleine Anzahl von Stichproben. Die systematische Überprüfung der topisch-pyhtotherapeutischen Produkte ­enthielt nur wenige klinische Studien und beinhaltete keine Metaanalyse.

Schlussfolgerung: Basierend auf der qualitativen Synthese kann eine Behandlung von OA mit Boswellia-serrata-Präparaten empfohlen werden. Zur Anwendung von ASU liegt nur unzureichende Evidenz hinsichtlich der Wirksamkeit vor. Aufgrund mangelnder randomisierter klinischer Studien kann keine gültige Empfehlung für oder gegen andere pflanzliche Präparate gegeben werden.

Key words

osteoarthritis - herbs - herbal therapy - phytotherapy - review

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