Efficacy and safety of willow bark extract in the treatment of osteoarthritis and rheumatoid arthritis: results of 2 randomized double-blind controlled trials

OBJECTIVE: To investigate the efficacy and safety of a standardized willow bark extract in patients with osteoarthritis (OA) and rheumatoid arthritis (RA). METHODS: We studied 127 outpatients with hip or knee OA and a WOMAC pain score of at least 30 mm and 26 outpatients with active RA in 2 randomiz...

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Published in:	Journal of rheumatology Vol. 31; no. 11; pp. 2121 - 2130
Main Authors:	Claudia Biegert, Irmela Wagner, Rainer LÃ¼dtke, Ina KÃ¶tter, Claudia LohmÃ¼ller, Ilhan GÃ¼naydin, Katja Taxis, Lutz Heide
Format:	Journal Article
Language:	English
Published:	Toronto, ON The Journal of Rheumatology 01-11-2004 Journal of Rheumatology Publishing
Subjects:	Administration, Oral Anti-Inflammatory Agents, Non-Steroidal - therapeutic use Antirheumatic Agents - administration & dosage Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - drug therapy Arthritis, Rheumatoid - physiopathology Biological and medical sciences Diclofenac - therapeutic use Diseases of the osteoarticular system Double-Blind Method Female Health Status Humans Inflammatory joint diseases Male Medical sciences Middle Aged Miscellaneous. Osteoarticular involvement in other diseases Osteoarthritis Osteoarthritis - drug therapy Osteoarthritis - physiopathology Plant Bark - chemistry Plant Extracts - administration & dosage Plant Extracts - therapeutic use Salix - chemistry Severity of Illness Index Treatment Outcome Knee Human Prognosis Evaluation scale Toxicity Diseases of the osteoarticular system Autoimmune disease Inflammatory joint disease Extract OSTEOARTHRITIS RHEUMATOID ARTHRITIS WILLOW BARK DICLOFENAC DRUG THERAPY Method Hip Diclofenac Chronic Pain Treatment Analog Rheumatoid arthritis Arthropathy Degenerative disease Ambulatory Osteoarthritis
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Summary:	OBJECTIVE: To investigate the efficacy and safety of a standardized willow bark extract in patients with osteoarthritis (OA) and rheumatoid arthritis (RA). METHODS: We studied 127 outpatients with hip or knee OA and a WOMAC pain score of at least 30 mm and 26 outpatients with active RA in 2 randomized, controlled, double-blind trials with followup for 6 weeks. OA trial: Patients were randomized to receive willow bark extract, corresponding to 240 mg of salicin/day, diclofenac 100 mg/day, or placebo (n = 43, 43, and 41, respectively). Main outcome measure was the pain subscore of the WOMAC OA Index. RA trial: Patients were randomized to receive willow bark extract, corresponding to 240 mg salicin/day (n = 13) or placebo (n = 13). Main outcome measure was the patient's assessment of pain rated on a 100 mm visual analog scale (VAS). RESULTS: OA trial: WOMAC pain scores decreased by 8 mm (17%) in the willow bark group and by 23 mm (47%) in the diclofenac group, compared with 5 mm (10%) in the placebo group. The difference between willow bark extract and placebo was not statistically significant (-2.8 mm; 95% CI -12.1 to 6.4 mm; p = 0.55, ANCOVA), but the difference between diclofenac and placebo was highly significant (-18.0 mm; 95% CI -27.2 to -8.8 mm; p = 0.0002, ANCOVA). RA trial: The mean reduction of pain on the VAS was -8 mm (15%) in the willow bark group compared with -2 mm (4%) in the placebo group. The difference was not statistically significant (estimated difference -0.8 mm; 95% CI -20.9 to 19.3 mm; p = 0.93, ANCOVA). CONCLUSION: The OA study suggested that the willow bark extract showed no relevant efficacy in patients with OA. Similarly, the RA trial did not indicate efficacy of this extract in patients with RA.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0315-162X 1499-2752