The effects of garlic (Allium sativum) supplementation on inflammatory biomarkers, fatigue, and clinical symptoms in patients with active rheumatoid arthritis: A randomized, double-blind, placebo-controlled trial.

Based on the antiinflammatory properties of garlic, current study was conducted to evaluate the garlic supplement effects on serum levels of some inflammatory biomarkers, clinical symptoms, and fatigue in women with active rheumatoid arthritis. In this randomized, double-blind, placebo-controlled trial study, 70 women with RA were randomly divided into two groups: The intervention group was supplemented with 1,000 mg of garlic, and the control group received placebo for 8 weeks. At baseline and at the end of the study, clinical symptoms, fatigue, serum level of C-reactive protein (CRP), tumor necrosis factor-a (TNF-a), and erythrocyte sedimentation rate (ESR) were determined. After intervention, serum levels of CRP (p = .018) and TNF-a (p < .001) decreased significantly in the garlic group as compared with the placebo group. Also, pain intensity, tender joint count, disease activity score (DAS-28), and fatigue were significantly decreased in the intervention group compared with the control group (p < .001; for all). Swollen joint count was significantly decreased in the garlic group (p < .001), but not in the placebo group (p = .123). No significant changes were observed for ESR. Garlic supplementation by improving inflammatory mediators and clinical symptoms can be considered as a potential adjunct treatment in patients with RA. However, further studies with larger duration are needed.

Efficacy and safety of topical Matricaria chamomilla L. (chamomile) oil for knee osteoarthritis: A randomized controlled clinical trial.

OBJECTIVE: To assess the efficacy and safety of topical Matricaria chamomilla (Chamomile) oil in patients with knee osteoarthritis. METHOD: Patients were randomized and treated with topical chamomile oil, diclofenac or placebo, 3 times/day for 3 weeks. They were allowed to use acetaminophen as analgesic. The patients were asked about their total acetaminophen use. Moreover, they were assessed in the terms of pain, physical function and stiffness by using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire at the enrolling and weekly. RESULTS: Chamomile oil significantly reduced the patients' need for acetaminophen (P = 0.001) compared with diclofenac and placebo. However, there were no significant differences in WOMAC questionnaire domains. The patients did not report any adverse events by using chamomile oil. CONCLUSION: Chamomile oil decreased the analgesic demand of patients with knee osteoarthritis. In addition, it may show some beneficial effects on physical function, and stiffness of the patients.

Infliximab for patients with neuro-Behcet's disease: case series and literature review.

This study aims to report the therapeutic effects of anti-tumor necrotic factor antibody, infliximab, for treatment of neuro-Behcet's disease (NBD) and to review the literature. We described four patients (all male, median age 40 years old) who fulfilled the International Study Group criteria for Behcet's disease (BD) and presented with neurological complication. Demographic and clinical characteristics of the patients, dose, therapeutic effects, and adverse drug reaction (ADR) of infliximab were reported. Two patients had secondary progressive, one relapsing progressive, and one primary progressive course (median duration of BD and NBD 11 and 2 years, respectively). Two patients each received infliximab with 3 and 5 mg/kg infusions, respectively. The patients received infliximab for median of 22 weeks. Clinical responses were unsatisfactory for two patients on 3 mg/kg regimen; and good in two patients on 5 mg/kg and monthly intravenous 500-1,000 mg cyclophosphamide. Varicella zoster infection was seen as a major ADR in one patient. Our results with infliximab were not as promising as the previous reports. Infliximab, 5 mg/kg per dose with adjuvant immunosuppressive therapy, is probably more effective than other regimens.