M W Whitehouse1, M S Roberts, P M Brooks. 1. Department of Medicine, University of Queensland, Princess Alexandra Hospital, 4102, Woolloongabba, Queensland, Australia. dbutters-michaelw@powerup.com.au
Abstract
BACKGROUND: Increasingly patients resort to alternative remedies for arthritis and rheumatism, perhaps partly impelled by reports of toxicities from prescribed non-steroid anti-inflammatory drugs (NSAID). There is uncertainty about whether the most common alternative treatments provide relief or may cause adverse reactions. AIM: To ascertain the validity of manufacturers' claims permitted by the Therapeutic Goods Administration (TGA) in Australia for a range of self-medication products to treat the pain and inflammation of arthritis, available in local pharmacies, supermarkets or by mail order and in other countries. METHODS: OTC products were administered orally to rats in standard assays for suppressing experimental arthritis and fever and for determining potential gastrotoxicity. RESULTS: The three NSAIDs available OTC were efficacious but gastrotoxic. Of the 37 herbal formulations examined, seven were as effective as ibuprofen in the anti-arthritic assay without causing gastric bleeding. Five of the 10 animal-sourced products tested were also effective without evident toxicity. Within a certain class of product, e.g. celery seed extracts or dried mussel preparations, efficacies ranged from almost zero to highly effective. CONCLUSIONS: Consumers currently have no guide to the likely efficacy of TGA-approved remedies. Quality control is urgently needed to justify the veracity of TGA-permitted and other claims on product labels.
BACKGROUND: Increasingly patients resort to alternative remedies for arthritis and rheumatism, perhaps partly impelled by reports of toxicities from prescribed non-steroid anti-inflammatory drugs (NSAID). There is uncertainty about whether the most common alternative treatments provide relief or may cause adverse reactions. AIM: To ascertain the validity of manufacturers' claims permitted by the Therapeutic Goods Administration (TGA) in Australia for a range of self-medication products to treat the pain and inflammation of arthritis, available in local pharmacies, supermarkets or by mail order and in other countries. METHODS: OTC products were administered orally to rats in standard assays for suppressing experimental arthritis and fever and for determining potential gastrotoxicity. RESULTS: The three NSAIDs available OTC were efficacious but gastrotoxic. Of the 37 herbal formulations examined, seven were as effective as ibuprofen in the anti-arthritic assay without causing gastric bleeding. Five of the 10 animal-sourced products tested were also effective without evident toxicity. Within a certain class of product, e.g. celery seed extracts or dried mussel preparations, efficacies ranged from almost zero to highly effective. CONCLUSIONS: Consumers currently have no guide to the likely efficacy of TGA-approved remedies. Quality control is urgently needed to justify the veracity of TGA-permitted and other claims on product labels.
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