A study conducted at the Arya Vaidya Pharmacy Research Foundation comparing the efficacy of classical ayurvedic treatment for rheumatoid arthritis and its modern medicine equivalent, methotrexate, has been selected in the category of Clinical Research for Excellence in Integrative Medicine Research Awards. The award constituted by the European Society for Integrative Medicine (ESIM), with support from Heel, a pharmaceutical company that develops, manufactures and distributes medicines based on natural substances, is given for the international research in integrative medicine, said P Ram Manohar, director and chief scientific officer, AVP Research Foundation.
He told TOI that the study has for the first time provided proof that classical individualized ayurvedic treatment can be studied using a randomized clinical trial design, the gold standard for clinical evidence in modern medicine. The study began in 2003 with the help of NCCAM, a division of National Institutes of Health, USA, which awarded a research grant of Rs 1.3crore to the Ayurvedic Trust through the University of Washington, Seattle, USA and was completed in 2008 in collaboration with the University of California, Los Angeles.
"As part of the study a double-blind, placebo-controlled, randomized clinical trial was conducted comparing classical ayurvedic treatment for rheumatoid arthritis with methotrexate in 45 patients by randomizing them into three groups -- one group receiving the ayurvedic treatment, the second group receiving methotrexate, and the third group a combination of both," Ram said, adding that for purposes of blinding, the first group were administered placebo methotrexate and the second group placebo ayurvedic medications. It is for the first time ever, placebos were developed for classical dosage forms in ayurveda -- decoctions, herbal powders, medicated oils, medicated jam, medicated wines and pills, he noted.
The study found significant improvement in the ayurvedic group. The outcome of the treatment was analyzed on the basis of American College of Rheumatology criteria and the duration of the study was of nine months. The number of painful and swollen joints, inflammatory markers like erythrocyte sedimentation rate and C-reactive protein, rheumatoid arthritis specific tests, disease outcome measures were employed to diagnose the disease as well as evaluate the efficacy of the treatments administered, he said.
The results indicated that the outcome of the ayurvedic treatment and methotrexate were approximately equivalent in efficacy, with numerically fewer adverse events noted in the ayurvedic group. The combination of ayurveda and methotrexate did not do as well as the other two groups. There was a significant improvement in the ayurvedic group at the end of nine months.
The study was published then in the prestigious Annals of the Rheumatic Diseases, a respected journal for rheumatology studies, in 2011. The full text of the study was published in the Journal of Clinical Rheumatology later. It was adjudged the best paper worldwide in Integrative Medicine Research in the last two years by a special jury constituted for the purpose by European Society of Integrative Medicine, Ram claimed. "For us it was a great achievement since Dr Edzard Ernst, a vehement critic of complementary and alternative medicine (CAM), said this study ought to be the blue print for future studies on CAM. This is a rare and unprecedented instance of ayurveda being recognized in the domain of integrative medicine in the global scenario," he said.
The Indian team in the study included P R Krishna Kumar, project director and managing director of AVP, P Ram Manohar, principal investigator, along with six others. The US team comprised of Daniel Furst, clinical lead investigator, Manorama Venkatraman, program director, Cathryn Booth La Force, principal investigator and Mary McGann, statistician.
The ESIM research prize is awarded in two categories: one for clinical investigations and the other for basic research. The two winners are awarded 10,000 euros each.
Submissions were based on a scientific manuscript that has either been published in a peer-reviewed journal in 2011 or 2012, or has been accepted for publication. The jury, made up of a selection of international experts in integrative medicine, rated the papers according to three criteria: innovation, level of relevance and scientific excellence, he added.
The winners will be announced at the 5th annual European Conference on Integrative Medicine (ECIM) to be held in Florence, Italy from September 21 to 22.
Source:TNN
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