Herbal Medicines Show Promise in Easing Acute Gouty Arthritis Pain

Korea: A new systematic review and meta-analysis have shed light on a potential breakthrough in the treatment of acute gouty arthritis, a condition known for its excruciating pain and discomfort. The study, which delved into the efficacy and safety of external herbal medicines for this ailment, suggests that these remedies may offer a safe and effective alternative to conventional Western medicine treatments. 

The study results were published in the journal Medicine (Baltimore) on September 15, 2023. 

Acute gouty arthritis, characterized by its excruciating pain, has long posed a significant challenge in the realm of medical treatment. Conventionally managed with nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine, this condition often comes with its own set of side effects, leaving patients and healthcare providers searching for safer and more effective alternatives. In light of this pressing need, a research team from Korea under the guidance of Choi Su Hyeon conducted a systematic review and meta-analysis to evaluate the efficacy and safety of herbal medicines acting directly on the affected area of acute gouty arthritis for external use. 

Researchers scoured four electronic databases, including PubMed, EMBASE, CNKI, and Cochrane, from their inception to February 2023, to gather data from 27 clinical studies. These studies were randomized controlled trials specifically focused on external herbal medicines as a treatment for acute gouty arthritis. The total effective rate, uric acid level, pain score, and inflammatory factor levels such as erythrocyte sedimentation rate and C-reactive protein were assessed for outcomes. The comprehensive analysis included 1951 participants across the 27 studies. The results were highly encouraging. 

The results: 

• The most striking finding was that the external use of herbal medicines outperformed Western medicine in managing acute gouty arthritis.
• These herbal remedies proved significantly more effective in reducing pain, inflammation, and uric acid levels—the hallmarks of this condition. 
• As it comes to safety concerns, out of the 10 studies that mentioned side effects, four reported no side effects at all. In the remaining six, the intervention group that used herbal medicines experienced notably fewer complications compared to the control group receiving conventional Western medicine.

The study's findings indicate that the external use of herbal medicines might fill the void in managing acute gouty arthritis. By providing notable relief from pain and inflammation while maintaining a favorable safety profile, these herbal remedies could be a game-changer in the management of acute gouty arthritis. However, the included studies exhibited heterogeneity in terms of interventions, outcomes, and regional biases. Therefore, further research is essential to solidify the evidence base. 

Further reading: Choi SH, Song HS, Hwang J. Herbal medicine for external use in acute gouty arthritis: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2023;102(37):e34936. doi:10.1097/MD.0000000000034936