scholarly journals Use of Herbal Medications for Treatment of Osteoarthritis and Rheumatoid Arthritis

Medicines ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 67
Author(s):  
Breanna N. Lindler ◽  
Katelyn E. Long ◽  
Nancy A. Taylor ◽  
Wei Lei
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trials ◽  
The United States ◽  
Pharmacological Therapy ◽  
Effective Management ◽  
Pharmacological Interventions ◽  
Safety And Efficacy ◽  
Herbal Medications ◽  
Anti Oxidant

Arthritis is a chronic condition that affects nearly a quarter of the United States population. Osteoarthritis (OA) and rheumatoid arthritis (RA) are two major forms of arthritis associated with severe joint pain and reduced quality of life. Various pharmacological interventions may be utilized for arthritis treatment when non-pharmacological therapy is insufficient. However, pharmacological therapy can be associated with serious side effects and high costs. Therefore, alternative therapies have been under investigation. Herbal medications have shown the potential for safe and effective management of arthritis. For this review, we attempt to summarize the mechanisms, safety, and efficacy of herbal treatments for OA and RA. After searching electronic databases, we identified nine herbs among 23 clinical trials used for the treatment of OA or RA patients. Improvement of OA and RA symptoms, pain, and inflammation was demonstrated. The herbs exhibited strong anti-inflammatory and anti-oxidant activities, contributing to a reduction in inflammation and tissue damage. Several herbs elucidated new mechanisms for OA and RA treatment as well. Though these herbs have shown promise for OA and RA treatment, more studies and clinical trials are required for determining safety and efficacy, bioactivity, and optimal bioavailability.

scholarly journals Recent Developments in Clinical Applications of Mesenchymal Stem Cells in the Treatment of Rheumatoid Arthritis and Osteoarthritis

2021 ◽  
Vol 12 ◽  
Author(s):  
Joel Jihwan Hwang ◽  
Yeri Alice Rim ◽  
Yoojun Nam ◽  
Ji Hyeon Ju
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trials ◽  
Clinical Applications ◽  
Clinical Settings ◽  
Positive Outcomes ◽  
Joint Function ◽  
Safety And Efficacy ◽  
High Expectations ◽  
Recent Developments

Mesenchymal stem cell (MSC) therapies have been used as cell-based treatments for decades, owing to their anti-inflammatory, immunomodulatory, and regenerative properties. With high expectations, many ongoing clinical trials are investigating the safety and efficacy of MSC therapies to treat arthritic diseases. Studies on osteoarthritis (OA) have shown positive clinical outcomes, with improved joint function, pain level, and quality of life. In addition, few clinical MSC trials conducted on rheumatoid arthritis (RA) patients have also displayed some optimistic outlook. The largely positive outcomes in clinical trials without severe side effects establish MSCs as promising tools for arthritis treatment. However, further research is required to investigate its applicability in clinical settings. This review discusses the most recent advances in clinical studies on MSC therapies for OA and RA.

scholarly journals Effects of Social Determinants of Health in Progression to Type 2 Diabetes

2021 ◽  
Author(s):  
◽  
Folabi Ariganjoye ◽  
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Type 2 Diabetes ◽  
Social Determinants ◽  
The United States ◽  
Effective Management ◽  
The World ◽  
Longitudinal Association

The prevalence of prediabetes and diabetes in the United States and around the world has increased faster than expected in the last 30 years. The economic burden this costs a nation can be astronomic both in terms of expense and loss in productivity. One-third of U.S. adults, 86 million people, have prediabetes. Effective management is needed that can reach these 86 million, and others at high risk, to reduce their progression to diagnosed Type 2 diabetes. After the literature review, there was not enough literature to support how these led to the progression to diabetes. The abundant literature is centered on how to prevent complications and improve the quality of life of those living with type 2 diabetes. This paper will focus on the longitudinal association between these social determinants and how they may predispose to the progression to Type 2 diabetes.

scholarly journals Safety and efficacy of ADS-5102 (amantadine) extended release capsules to improve walking in multiple sclerosis: A randomized, placebo-controlled, phase 2 trial

2018 ◽  
Vol 25 (4) ◽  
pp. 601-609 ◽  
Author(s):  
Jeffrey A Cohen ◽  
Samuel F Hunter ◽  
Theodore R Brown ◽  
Mark Gudesblatt ◽  
Ben W Thrower ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Extended Release ◽  
The United States ◽  
Timed Up And Go ◽  
Double Blind ◽  
Once Daily ◽  
Safety And Efficacy ◽  
Phase 2 Trial ◽  
Minute Walk

Background: Walking impairment causes disability and reduced quality of life in patients with multiple sclerosis (MS). Objective: Characterize the safety and efficacy of ADS-5102 (amantadine) extended release capsules, 274 mg administered once daily at bedtime in patients with MS with walking impairment. Methods: This randomized, double-blind, placebo-controlled, 4-week study was conducted at 14 trial sites in the United States. Study objectives included safety and tolerability of ADS-5102, and efficacy assessments (Timed 25-Foot Walk (T25FW), Timed Up and Go (TUG), 2-Minute Walk Test, and Multiple Sclerosis Walking Scale-12). Fatigue, depression, and cognition also were assessed. Results: A total of 60 patients were randomized (30 to ADS-5102 and 30 to placebo); 59 of whom were treated. The most frequent adverse events (AEs) were dry mouth, constipation, and insomnia. Five ADS-5102 patients and no placebo patients discontinued treatment due to AEs. One patient in the ADS-5102 group experienced a serious AE—suspected serotonin syndrome. A 16.6% placebo-adjusted improvement was seen in the T25FW test ( p < 0.05). A 10% placebo-adjusted improvement in TUG was also observed. No changes in fatigue, depression, or cognition were observed. Conclusion: ADS-5102 was generally well tolerated. These data demonstrate an effect of ADS-5102 on walking speed. Further studies are warranted to confirm these observations.

scholarly journals Can prospective systematic reviews of animal studies improve clinical translation?

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Pandora Pound ◽  
Merel Ritskes-Hoitinga
Keyword(s):  
Clinical Trials ◽  
Systematic Reviews ◽  
Animal Studies ◽  
Poor Quality ◽  
Human Studies ◽  
Clinical Knowledge ◽  
Safety And Efficacy ◽  
High Quality Evidence ◽  
Animal Data

AbstractSystematic reviews are powerful tools with the potential to generate high quality evidence. Their application to animal studies has been instrumental in exposing the poor quality of these studies, as well as a catalyst for improvements in study design, conduct and reporting. It has been suggested that prospective systematic reviews of animal studies (i.e. systematic reviews conducted prior to clinical trials) would allow scrutiny of the preclinical evidence, providing valuable information on safety and efficacy, and helping to determine whether clinical trials should proceed. However, while prospective systematic reviews allow valuable scrutiny of the preclinical animal data, they are not necessarily able to reliably predict the safety and efficacy of an intervention when trialled in humans. Consequently, they may not reliably safeguard humans participating in clinical trials and might potentially result in lost opportunities for beneficial clinical treatments. Furthermore, animal and human studies are often conducted concurrently, which not only makes prospective systematic reviews of animal studies impossible, but suggests that animal studies do not inform human studies in the manner presumed. We suggest that this points to a confused attitude regarding animal studies, whereby tradition demands that they precede human studies but practice indicates that their findings are often ignored. We argue that it is time to assess the relative contributions of animal and human research in order to better understand how clinical knowledge is actually produced.

scholarly journals Update on the Treatment of Idiopathic Hypersomnia

2019 ◽  
Vol 5 (4) ◽  
pp. 207-214
Author(s):  
M. S. Schinkelshoek ◽  
R. Fronczek ◽  
G. J. Lammers
Keyword(s):  
Treatment Options ◽  
Pharmacological Therapy ◽  
Small Sample ◽  
Treatment Modalities ◽  
Lifestyle Advice ◽  
Pharmacological Interventions ◽  
First Choice ◽  
Idiopathic Hypersomnia ◽  
Small Sample Sizes

Abstract Purpose of Review Idiopathic hypersomnia is an incapacitating disorder with a profound impact on daytime performance and quality of life. The most commonly used treatment modalities are lifestyle advice and pharmacological therapy. We present an update on the evidence concerning treatment options for idiopathic hypersomnia. Recent Findings Evidence for non-pharmacological interventions is lacking; improvement in symptoms on introducing these interventions is often less pronounced than in narcolepsy. Additional pharmacological treatment is therefore usually initiated. The few treatment studies that have been performed are hampered by small sample sizes and the use of variable and often insufficiently validated outcome parameters for the whole spectrum of idiopathic hypersomnia symptoms. Conclusion Evidence on treatment is scarce. Since the efficacy of modafinil is consistently described and there is much experience with this substance, it is reasonable to start with modafinil as a first choice treatment. Methylphenidate and dexamphetamine are good alternatives. In the future, newer drugs such as sodium oxybate, pitolisant, and solriamfetol might be authorized for use in idiopathic hypersomnia.

Quality of systemic cancer therapy in routine care: What are we measuring?

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 249-249
Author(s):  
Shixin (Cindy) Shen ◽  
Monika K. Krzyzanowska
Keyword(s):  
Clinical Trials ◽  
Cancer Therapy ◽  
The United States ◽  
Cytotoxic Chemotherapy ◽  
System Level ◽  
Patient Specific ◽  
Routine Practice ◽  
Treatment Delivery ◽  
Early Stage Disease

249 Background: While clinical trials provide efficacy and early safety information regarding systemic cancer therapy (ST), most cancer patients who receive ST are treated outside clinical trials. We performed a systematic review of studies that have evaluated the quality of ST in routine practice to summarize the literature and define knowledge gaps across five quality domains – access, treatment delivery, toxicity, safety and outcome. Methods: We searched MEDLINE using a combination of terms pertaining to ST, such as “chemotherapy” with keywords related to healthcare quality for articles published in English from January 1, 2000 to December 31, 2010. Articles were included if they were based on original studies that examined quality of ST among adult patients from a population perspective (defined as multiple institutions). Study information was abstracted using a standardized form. Summary statistics were used to describe the results. Results: Our search identified 179 articles. The number of studies published each year increased over time from nine studies in 2000 to 30 in 2010. Most studies were conducted in the United States (58%) in either colorectal (31%) or breast cancers (27%) and focused on adjuvant intent cytotoxic chemotherapy (81%). Majority of the studies retrospectively (92%) identified patients from cancer registries (83%) and used either billing data (64%) or information in the registry itself (27%) for treatment identification. 66% of the studies evaluated a single quality domain, whereas the remaining articles assessed two or more domains. No study was found that examined safety from a population perspective. Access was the most frequently evaluated domain (77%) whereas treatment delivery was the least examined (12%). Treatment toxicity and outcome were evaluated in 21% and 31% of studies, respectively. Among studies that assessed outcome of ST, most evaluated patient specific outcomes such as survival (93%) although a few (13%) examined system level outcomes such as cost. Conclusions: Majority of studies evaluating quality of ST have focused on access to cytotoxic chemotherapy in early stage disease. Further studies focusing on other aspects of quality and in different clinical settings are needed.

scholarly journals THE CONCEPT AND MANAGEMENT OF WAJAUL MAFASIL IN UNANI MEDICINE

2021 ◽  
pp. 7-13
Author(s):  
ZEHRA ZAIDI
Keyword(s):  
Side Effects ◽  
Clinical Studies ◽  
Pharmacological Therapy ◽  
Phase Iii ◽  
Herbal Drugs ◽  
Effective Management ◽  
Unani Medicine ◽  
Herbal Medications ◽  
Classical Knowledge

More than 54 million Americans suffer from some form of arthritis and 23.7 million are limited in their usual activity, primarily due to pain. The study aims to highlight the concept of Arthralgia and the potential of its management in Unani Medicines. Osteoarthritis (OA) is a slowly progressive condition with a variable prognosis. In general, predicting the prognosis in patients with OA is difficult. However, pharmacological therapy can be associated with serious side effects and high costs. Therefore, alternative therapies have been under investigation. Herbal medications have shown the potential for safe and effective management of arthritis. The Unani Medicine is a rich source of classical knowledge on arthritis. OA has been mentioned as Wajaul Mafasil Balghami/Saudawi, and Unani Physicians has been treating this disease successfully with mostly single herbal drugs and their compound formulations for centuries. It has been revealed through animal, in vitro, and clinical studies that most of the single and compound Unani formulations are safe, without any side effects, and effective in OA, especially gout and rheumatoid arthritis. There is a need to conduct studies at Phase III level after analyzing 2nd Phase clinical studies of Unani medicine, so a promising safe, economic, and effective treatment can be provided to the ailing society for OA.

scholarly journals Delivering Equitable Care to Underserved Neuro-oncology Populations

2021 ◽  
pp. 1-9
Author(s):  
Alyx B. Porter ◽  
Ugonma N. Chukwueke ◽  
Aaron G. Mammoser ◽  
Bret Friday ◽  
Shawn Hervey-Jumper
Keyword(s):  
Clinical Trials ◽  
Multidisciplinary Care ◽  
The United States ◽  
Limited Attention ◽  
Provider Education ◽  
Supportive Services ◽  
Marginalized Communities ◽  
Underserved Groups ◽  
Oncologic Diseases

It is widely recognized that subspecialized multidisciplinary care improves neuro-oncology outcomes. Optimizing patient outcomes relies on the expertise of the treating physicians, neuroradiology and neuropathology, and supportive services familiar with common neurologic syndromes that occur after brain tumor diagnosis and treatment. Despite an increasing number of providers, patient access to specialized multidisciplinary care and clinical trials remains limited. Barriers to equitable health care exist across the United States, with marginalized communities being impacted disproportionately. Such disparity causes increased morbidity and mortality for patients from backgrounds with various elements of diversity. Limited attention to this inequity has resulted in an incomplete understanding of the spectrum of experiences that patients with neuro-oncologic diseases encounter. Clinical trials represent the highest standard and quality of care in medicine, but inclusion of under-represented and underserved groups consistently lags behind counterpart participants from majority racial and ethnic groups. Through provider education as it pertains to issues from bias and health literacy to increasing clinical trial enrollment and offering opportunities through telemedicine, opportunities for improving access to high-quality neuro-oncologic care are explored.

scholarly journals Acupressure and Dementia - A Review of Current Evidence

2021 ◽  
Author(s):  
Soo Liang Ooi ◽  
Gillian Drew ◽  
Sok Cheon Pak
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Sleep Disturbances ◽  
Psychological Symptoms ◽  
Pharmacological Therapy ◽  
Current Evidence ◽  
High Quality Research ◽  
Dementia Patients ◽  
Moderate Dementia

Introduction: Dementia is a cognitive decline with patients often exhibit behavioural and psychological symptoms, severely affecting the quality of life and placing a heavy burden on caregivers. Acupressure has reported benefits for dementia. This study aims to critically review the available evidence for its use as a non-pharmacological therapy. Methods: Systematic search of major research databases for human clinical trials using acupressure as an intervention for dementia patients was conducted. Results were synthesised for the effects of acupressure on various outcome measures of interest for dementia.Results: Twelve clinical trials (N=973), including eight randomised control studies, were included in this review. The study sample was predominantly institutionalised residents with moderate to severe dementia. Baihui (GV20), Shenmen (HT7), Fengchi (GB20), Neiguan (PC6), Sanyinjiao (SP6), and Yingtang (EX-HN3) were the most used acupoints for intervention. Acupressure techniques employed in these clinical trials vary greatly with no standardised approach. This review finds inconsistent evidence in the effectiveness of acupressure in reducing agitation and behavioural disturbances. However, the treatment appears to improve their ease of care and reduce physical stress. Affixing acupressure devices on selected acupoints can also potentially improve psychiatric pain, anxiety, and depression. Long-term (6 months) treatment can potentially improve the cognitive function, activities of daily living, and quality of life of patients with mild to moderate dementia. The effect of acupressure on sleep disturbances remains unclear. Conclusion: More high-quality research on acupressure is needed to fill the gaps in knowledge and inform better care for dementia patients in the future.

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