Abstract
Background: There is evidence that oxidative stress plays an important role in autoimmune diseases, such as rheumatoid arthritis (RA). Despite the supporting evidence for a beneficial effect of antioxidants on clinical characteristics of RA, the right balance for optimal effectiveness of antioxidants is largely unknown. A study was designed to determine the potential beneficial effects of antioxidant intervention on clinical parameters of RA.Methods: Randomized clinical trial of 152 patients with positive rheumatoid factor (RF) and a Disease Activity Score (DAS 28) higher than 3.2 were enrolled in the study. Patients were divided into two groups (Group A and Group B) randomly and group A received methotrexate and antioxidant vitamins (A, C and E in a fixed dose) and group B methotrexate only. They were followed up for three visits (baseline, 10th week and 14th week). The intervention was stopped after 10 weeks and was followed by a ‘wash-out’ period of 4 weeks. At baseline, 10th week and 14th week patient’s condition were assessed by means of DAS-28 score. P- Value less than <0.05 was considered significant.Results: The numbers of swollen and tender joints were significantly reduced and general health was improved reflected by improved DAS-28 score at 10th week.The antioxidant effect was considered beneficial as compared to the scores of 1st visit at baseline; the DAS-28 score was significantly reduced at 2nd visit at 10th week. Increment of the DAS-28 score among the group A patients who were on antioxidant up to10 weeks, after the “wash-out period” of four weeks i.e. at 14th week confirmed a significant relation between changes in clinical condition and antioxidants.Conclusion: This study was designed to assess the potential beneficial effect of antioxidants (Vitamin A, C and E) in combination with methotrexate in the treatment of RA.
Highlights
Rheumatoid arthritis (RA) is a chronic, inflammatory disorder that may affect many tissues and organs, but principally attacks flexible synovial joints
The numbers of swollen and tender joints were significantly reduced and general health was improved reflected by improved DAS28 score at 10th week
The antioxidant effect was considered beneficial as compared to the scores of 1st visit at base line; the Disease Activity Score (DAS)-28 score was significantly reduced at 2nd visit at 10th week
Summary
Rheumatoid arthritis (RA) is a chronic, inflammatory disorder that may affect many tissues and organs, but principally attacks flexible synovial joints. Methods: Randomized clinical trial of 152 patients with positive rheumatoid factor (RF) and a Disease Activity Score (DAS 28) higher than 3.2 were enrolled in the study. Patients were divided into two groups (Group A and Group B) randomly and group A received methotrexate and antioxidant vitamins (A, C and E in a fixed dose) and group B methotrexate only. They were followed up for three visits (baseline, 10th week and 14th week).
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