title: Bibliographical investigation of complementary alternative medicines for osteoarthritis and rheumatoid arthritis.
abstract: BACKGROUND
  A variety of complementary and alternative medicine (CAM) treatments are provided to the elderly. We investigated the efficacy and safety of CAM substances that are available to patients with osteoarthritis (OA) and rheumatoid arthritis (RA), both in Japan and overseas.
  
  
  METHODS
  Information on CAM products was collected from the World Wide Web, using the keywords "arthritis" and "supplement" in five languages (Japanese, English, French, Italian and German) using a popular search engine for each of the languages. References to published work on the products were researched using PubMed with the keywords of "arthritis", "anti-inflammatory" and "analgesics". Such published work was classified according to the evidence levels established by the Cochrane Library.
  
  
  RESULTS
  Two-hundred and sixty CAM products for OA or RA were available in Japan, of which 41 CAM products had been tested in randomized controlled trials (RCT); there was no scientific evidence for the remaining 219 CAM products. Most of the previous RCT suggested that CAM was effective in OA or RA. Herein, we confirmed the significant OA relieving effects of chondroitin sulfate through a meta-analysis. Effectiveness was assessed using subjective scores, not disease-specific immunological or serological markers for assessment. Toxicological investigations had only been performed for a few CAM products.
  
  
  CONCLUSIONS
  Some CAM products that are effective against RA may be used together with biological therapy. However, some of the CAM products available in Japan should be tested using objective markers. Some CAM products for OA could be used for the relief of pain.
authors.affiliation: Department of Medicine, Fujita Health University, Nanakuri Sanatorium, Tsu, Mie, Japan. mtkikuchi-u@umin.ac.jp
authors.forename: Motoo
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Matsuura
authors.forename: Yoshifuji
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Inagaki
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Ueda
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000628:therapy*; D001634:Bibliographies as Topic; D000529:Complementary Therapies; D006801:Humans; D020407:Internet; D010003:Osteoarthritis / Q000628:therapy*