DALLAS, TEXAS. A team of researchers from the University of Texas and the National Institutes of Health reports that an extract of the Chinese herbal remedy Tripterygium wilfordii Hook F (TWHF) has proven effective in the treatment of severe rheumatoid arthritis.

TWHF has been used for centuries in China to treat rheumatoid arthritis, ankylosing spondylitis, psoriasis, and IgA nephropathy. Preliminary studies in animals have shown that TWHF extracts have anti- inflammatory and immunosuppressive effects comparable to those of prednisone.

The researchers prepared their extract by extracting finely ground powder obtained from peeled TWHF roots with ethanol (alcohol) and ethyl acetate. The ethyl acetate extract was dried and put in capsules each containing 30 mg of the extract yielding a total of 9.9 micrograms of the active components triptolide and tripdiolide.

Thirteen patients with long standing rheumatoid arthritis participated in the trial. The initial dosage was 30 mg/day; this was gradually increased to 570 mg/day over a 12-18 month period. Nine of the patients went through the whole program. The patients all experienced marked improvement and one went into complete remission on a dose of 390 mg/day. Morning stiffness was the first symptom to improve. At baseline it lasted an average of 265 minutes. On a dose of 390 mg/day it reduced to 10 minutes. ESR (erythrocyte sedimentation rate) went from 55 mm/hour to 22 mm/hour on a dose of 480 mg/day. Sixty per cent of the patients experienced significant (more than 20 per cent) improvement on a dose of 180 mg/day. A dose of 300-480 mg/day was required for maximum benefit. This is comparable to the dosages used in China and was found to be entirely safe. The researchers are currently conducting a much larger, double- blind, controlled study to confirm the benefits of TWHF extracts.

Tao, Xuelian, et al. A phase I study of ethyl acetate extract of the Chinese antirheumatic herb Tripterygium wilfordii Hook F in rheumatoid arthritis. Journal of Rheumatology, Vol. 28, October 2001, pp. 2160-67