Abstract
Aim To review the published and unpublished experimental and clinical studies about the efficacy and tolerability of STW1 and to compare the results to the efficacy and tolerability of investigated NSAIDs in parallel. Content. STW1 (Phytodolor®) contains a fixed combination of extracts from aspen leaves and bark (Populus tremula), common ash bark (Fraxinus excelsior), and goldenrod herb (Solidago virgaurea). It belongs to the group of anti-inflammatory and antirheumatic drugs, and it is authorized for the treatment of painful disorders of degenerative and inflammatory rheumatic diseases. The individual components have complementary effects. Its multifocal mode of action includes antiphlogistic, analgesic, antiexudative, antioxidative, antipyretic, and antiproliferative properties. The effects of both STW1 and its components have been verified in comprehensive pharmacological investigations. Open and randomized, placebo- and verum-controlled, and single-blind (sb) or double-blind (db) clinical trials, performed in different subtypes of rheumatic diseases confirm the pharmacological evidence. Its efficacy is comparable to a range of standard nonsteroidal anti-inflammatory drugs (NSAIDs) studied in parallel, but it has a superior safety profile. Conclusion STW1 is a reasonable alternative to NSAIDs with comparable efficacy and a superior safety profile. It is also suitable to reduce the intake of NSAIDs.
Highlights
Many recent advances have been made in the scientific background and therapy of rheumatic diseases [1], but the exact etiology of most of these disorders is still unknown
STW1 showed potential for scavenging radical oxygen species (ROS) in different systems, which are relevant for the formation of ROS in vivo in inflammatory sites: rose bengal or riboflavin, Xanthine oxidase (XOD), diaphorase, and lipoxygenase, and it blocked both the peroxynitrite-dependent nitration and the enzyme- catalyzed reaction [8, 9]
Erefore, though herbal medicinal drugs do not seem to act faster than the disease-modifying antirheumatic drugs (DMARDs), they are frequently considered to be useful as adjuvant therapy for this condition. ey offer a versatile approach to treat the multidimensional nature of symptoms in osteoarthritis, rheumatic diseases, and musculoskeletal complaints, out of which chronic pain is the leading indication for their use. ey are especially valuable for geriatric patients, as they reduce pain, improve quality of life, maintain autonomy, avoid need of care, are well tolerated, and reduce taking of drugs with serious side effects
Summary
Many recent advances have been made in the scientific background and therapy of rheumatic diseases [1], but the exact etiology of most of these disorders is still unknown. Not all patients respond to therapy, and the efficacy of treatment varies with the characteristics of the patients including their genetic background and immune cell phenotype [2]. Drugs such as the newer biologicals are not sufficiently investigated for long-term or lifelong routine clinical use, especially with respect to their adverse effect profile. Complementary medical drugs are widely used by patients with rheumatic diseases. Complementary medical drugs are widely used by patients with rheumatic diseases. is has many potential implications in a group of predominantly elderly patients with altered pharmacokinetics, comorbidities, and polypharmacy of potentially toxic drugs [3, 4]
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