If you are suffering from Rheumatoid Arthritis (RA), you must have definitely gone through the dilemma of choosing the stream of medicine (Allopathic/ herbal/ ayurveda/ homeopathy)
During the initial consultation, I often notice that many RAers are misinformed about the allopathic anti arthritis drugs (either by general public or the alternative medicine practitioners) that —
· Allopathic anti-arthritis medicines are all steroids or pain-killers.
· Allopathy does not have any medicine for RA.
· RA never settles.
· Allopathic medicines are ‘powerful’ & eventually lead to kidney failure.
However, the truth is here—
· Allopathic anti arthritis medicines (DMARDs) are not steroids/ pain killers. They are actual drugs that hit the arthritis process.
· We do have effective medicines for RA & RA does get controlled in most of the patients.
While treating RA, the aim of a Rheumatologist is—
· To put the RA in remission as soon as possible.
· Long term steroids/ analgesics have no role in routine RA.
· To control RA activity with DMARDs/ biologics alone with analgesics only for flares.
Having said that, let us have a look at the side effects of the common DMARDs. I will keep an absolute neutral approach to avoid any bias. This will also be a scientific process with references to what we discuss. We will have a look at one DMARD at a time in the subsequent blogposts.
Before really looking at individual DMARD, let us have a look at the drug discovery process of any allopathic medicine. Each allopathic drug has to pass through a rigorous scientific process before hitting the doctor’s pen. The journey starts with scientific studies justifying the use of a molecule in any disease. This is followed by the study of the molecule in test tube & animals (Pre-clinical study). This is followed by a similar study in human subjects (Phase I to III to determine safety, tolerability & efficacy). The entire process takes anywhere between 10- 15 years !!
There are many examples of drugs being discarded due the side effects found in this process (eg. Ocrelizumab- a biologic drug for RA, Lupus, Multiple sclerosis was dumped during the clinical studies due to side effects) The average cost of research & development of a new drug entity is approximately US$1.8 billion.
Once the drug hits the market & is being prescribed, the post-marketing surveillance (Phase-IV) start. This includes looking for any unexpected side effects. Allopathic medicines have the advantage of scrutiny in multiple countries & consequent reporting of side effects from any part of the world. Cox-2 inhibitors have been one of the best examples of this level of scrutiny. They were banned once cardiovascular side effects were observed after their marketing & availability in the markets.
So, when it comes to allopathic medicines, be assured that a lot of efforts & time (remember the average time for a new drug is 10- 15 years!) have gone into ensuring your safety. Allopathic medicines are not a result of someone’s whims & fancy/ experience alone. In contrast, no such trials/ scrutiny exists for the herbal medicines/ magic cure medicines. In fact, most of the times, the contents of herbal medicines are not even printed on the pack.
Having said this, there is NOT A SINGLE MEDICINE WITHOUT ANY SIDE EFFECT. A drug is approved only when its benefits are many times more than its side effects. For any drug, there are a few side effects & having known that, there are checks & precautions as well as tests for early diagnosis of any side effect.
We will have a look at individual DMARD & its side effect profile in the subsequent blogs.
References:
1) Ocrelizumab — http://www.fiercebiotech.com/story/patient-death-mars-promising-ms-results-phii-ocrelizumab-trial/2010-10-18?utm_medium=nl&utm_source=internal
2) Ocrelizumab –http://www.reuters.com/article/idUSLDE62705720100308
3)cost of drug discovery process- Steven M. Paul, Daniel S. Mytelka, Christopher T. Dunwiddie, Charles C. Persinger, Bernard H. Munos, Stacy R. Lindborg & Aaron L. Schacht (2010). “How to improve R&D productivity: the pharmaceutical industry’s grand challenge”. Nature Reviews Drug Discovery 9 (3): 203–214. doi:10.1038/nrd3078. PMID 20168317.
Arthritis support board 
The information given above is an eye opener. It needs to be given wide publicity. I shall try to translate this blog in marathi, as it is a most important blog.
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We are aware of the efforts by drug industry and medical practitioners in bringing new and more effective drugs into the market and alleviate the suffering of the patients. However, if you can comment on the effectiveness of the other forms of medicine, more notably, ayurveda on the various forms of rheumatism.
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I am not an expert on ayurveda/ other alternative forms. May be I can ask some expert to write a guest article.
At the same time, we Rheumatologists & scientists are really working hard to alleviate pain & put RAers into remission. Every effort is taken to avoid side effects of the DMARDs.
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Form the experience of treatement of ayurveda, homoeopathy & other therapies etc of Osteo Arthritis,& RA for the last 18 years I could only find out that present DMARD treatment is the only best treatement available that puts the RA in to remission. May be I could not find a best Ayurvedic or Homoeopathic practitioner. But I did try with best Ayurvedic and Homoeopathic practitioners available in Mumbai area. We must also remember what is lost in the ware and tear or deformaties cannot be restored. What can be done is only to apply breaks on further damages and alluviate pains. That is best achieved with DMARD treatment.
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I’ll try & request an expert in ayurveda/ homeopathy to add to our knowledge. let us also look at the their point of view as well.
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i personally want to try homeopathy but when it comes to have only homeopathy n no allopathy it leaves us in doubt of whether that wud b effective or not….
moreover, nw i m even used to the side effects of meds…nw it looks as if i wont be able to live without all this drama 😛
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In most of the cases though they start with DMARDs, doctors prescribe methotrexate and steroids which have many side effects. I agree that there are no medicines without side effect. Infact even water becomes poisonous when taken in overdose as anything we take from outside will have some effect on our health.
But one fact people should not forget that whether its ayurveda or homeopathy, they also would have gone through many years of trials before deciding on a treatment regimen, and it does not arise out of “someone’s whims & fancy/ experience”. There are many studies nowadays carried on Alternative medicines, in the lines of classical allopathic medicine to prove their efficacy.
Alternative treatments should not be commented on like this just because its not tested in the same way as allopathic medicine. It would be good if people start investigating on how to cure a disease rather than confining ourselves to either allo[pathy or ayurveda. After all the cure is the main goal.
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I fully agree, Kavyashree.
We should be concentrating on curing/ treating a disease rather than confining ourselves to ayurveda/ homeopathy/ allopathy.
The post was aimed at assuring the patients that the drugs used go through a rigorous check before being used. It is a pity that a few patients deny methotrexate purely due to the fear of side effects. The side effects of not treating rheumatoid arthritis (in terms of deformity/ disability) are much more severe than the potential side effects of methotrexate.
We should encourage more studies of alternative therapy medicines to help arthritis patients.
One of the problems commonly faced with ayurvedic formulations is that the contents are known only to the prescribing doctor. It is based on personal experience/ knowledge & not open for study/ validation.
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Have you ever considered about including a little bit more than just your articles?
I mean, what you say is important and all. But think of if you added some great visuals or videos
to give your posts more, “pop”! Your content is excellent but
with images and clips, this website could undeniably be one of the greatest in its niche.
Terrific blog!
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Sir I could not agree with you,now a days ayurvedic is institutionalised the contents of the medicine is clearly mentioned in the labels and it is approved by government and AYUSH ,most of the herbs are validated by WHO and its efficacy over the diseases is clinically proved researches have been advanced in botanical science,the organic biochemical substances of herbs act miraculously in human and I personally heal it.
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Dear Siva,
I agree with you. AYUSH has made a big difference.
However, most practitioners still continue giving medicines without any labels.
Research in ayurvedic medicines is lacking as well.
I wish the government takes some concrete steps for research as well dispensing of these medicines.
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Sir,
The research made by Dr.Lakshmi chandra Mishra.,P.hd professor in research division in Southern California University of health sciences made on Rhuematoid arthritis never witnessed any side effects and even RA sle is completely curable even in advanced stage whereas research made for 2 decades before introducing a new medicine in allopathy clearly concluded the potential side effects of NSAIDs and Steroids.The research in ayurveda and herbal medicines may be less but at that same time scientificaly there is no evidence of harmful side effects mentioned in that small level of research further more the side effects are good in which the patient build more stamina and WBC count raises.If the Ayurvedic doctor is from good institution and posses valid MD degree and efficient in diagnoising the patient both in( ayurvedic and lab equipment based) then the patient would have changed their destiny to get recovered.
Thanks,
Siva.
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Dear Siva,
Can you please provide the links to the said study.
I am interested in knowing more about it.
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Definitely Sir, kindly go into http://www.progenresearchlab.com click Ayurveda article in left and download pdf file mentioned ayurveda and modern science and also go into Rumalaya forte by Himalaya herbals in google and there is a research article,and another research made by World Health Organization in coimbatore Tamilnadu titled as Eficacy of Ayurvedic Medicine over Rheumatoid Arthritis in google.
Thanks,
Siva.
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