Effect of Artemisia annua Extract on Treating Active Rheumatoid Arthritis: A Randomized Controlled Trial

Objective: To investigate the effect and safety of the complementary use of the extract of Artemisia annua L. (EAA) on treating active rheumatoid arthritis (RA). Methods: A randomized controlled clinical trial was performed. All the 159 participates with active RA were randomly assigned to the control group (80 cases) and EAA group (79 cases) using concealed random allocation method. In the control group, patients were medicated with leflunomide and methotrexate for 48 weeks; and patients in the EAA group were administrated with leflunomide, methotrexate plus EAA (30 g/d). At the time points of 0, 12, 24 and 48 weeks, the clinical outcome measures, including objective pain score, tenderness score, number of painful joints, number of swollen joints, health assessment questionnaire (HAQ) score for quality of life, levels of serum rheumatoid factor (RF), anti-cyclic citrullinated protein antibodies (CCP-Ab), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), visual analogue score for pain (VAS), and the overall efficacy were detected and recorded. Results: The objective pain score, number of painful joints and ESR at 12 weeks, tenderness score and HAQ at 24 weeks, and the tenderness score, number of painfull joints, number of swollen joints, HAQ, CRP, RF and CCP-Ab at 48 weeks were significantly improved in the EAA group compared with the control group (P < 0.01 or P < 0.05). At 24 and 48 weeks, the overall efficacy of the EAA group was significantly higher than the control group (P < 0.01). There were significantly higher withdrawal rate of corticosteroids within 12 weeks post-treatment and lower incidence rate of adverse effects in the EAA group compared with the control group (P < 0.01 or P < 0.05). Conclusion: EAA plus methotrexate and leflunomide were more effective and safer than the routine use of methotrexate and leflunomide in the treatment of active RA.