Application of Japanese Oriental Medicine for the Treatment of Rheumatoid Arthritis Complicated with Other Serious Diseases

Abstract

The therapeutic strategy for rheumatoid arthritis (RA) has markedly changed over the past 10 years. It has been recommended to achieve clinical remission and suppress articular destruction by treatment with an effective anti- rheumatic drug from an early stage. However, an alternative strategy to achieve low disease activity due to physical, social, and job-related problems was also recommended in the 2014 update of the recommendation for treating RA to target. In the last version, it is documented that the method of treatment should be determined based on mutual agreement between the physician and patient. It is also important to consider the treatment target and strategy for elderly RA patients in the future. In this trend, classical DMARDs (disease modifying anti-rheumatic drugs) are usually used for patients in whom anti-rheumatic drugs including methotrexate and biologics are contraindicated. We consider that there may be Kampo medicines acting as useful agents for these RA patients. Here, we present the clinical courses of RA patients complicated with respiratory infection and rectal cancer. Furthermore, we discuss the positioning of Kampo medicines in RA therapeutic strategies.