Efficacy of Seetarama Vati (A Sri Lankan traditional drug) and Vatari Guggulu in the management of Amavata (rheumatoid arthritis)-an open labeled randomized comparative clinical trial

INTRODUCTION: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease caused by type III hypersensitivity reaction due to antigen antibody complexes which deposit at the joints resulting in arthritis. As per the concept of Ayurveda, it can be co-related with Amavata, the disease arising from deranged metabolism and Vata vitiation. Despite of advancement in diagnostic approach of RA, management of it remains challenge. Vatari Guggulu and Seetarama Vati are the formulations having analgesics properties due to their Ushna (metabolism enhancing) and Tikshna Guna (micro channel cleaning) and simultaneously possess anti-inflammatory properties. AIMS AND OBJECTIVES: To evaluate and compare the efficacy of Vatari Guggulu and Seetarama Vati in the management of Amavata w.s.r. to rheumatoid arthritis. MATERIAL AND METHODS: For the present study, 58 patients were selected and divided into two groups. Patients of group A and group B were given Vatari Guggulu and Seetarama Vati respectively with warm water after meal for one month. Before administration of trial drugs in both of groups’ patients were given 4-6 grams of Triphala powder depending upon the Koshtha of the patient, on empty stomach early morning for the purpose of Koshtha Shuddhi (purgation) for 3 days. In addition to assess effect on signs and symptoms of Amavata, haematological investigation, biochemical investigation including quantitative C-reactive protein (CRP) and rheumatoid factor (RA factor) and routine urinary examination were carried out before and after treatment in all the registered patients. The effect of therapy was assessed on the basis of changes in score in comparison to end point score. DISCUSSION: All the cardinal and associate complaints were statistically significant improved after the course of the trial drug. Most of the functional parameters had statistically significant improvement after treatment except left side foot pressure and DAS 28 scale in B group. Biochemical and hematological parameters were within normal limit before and after treatment. The difference of effect of trial drug on chief complaints was statistically insignificant. The difference of effect of trial drug on associate complaints was statistically insignificant. Difference of effect of trial drugs on ESR of both the groups was statistically insignificant. The difference of effect of trial drug on RA factor and CRP between groups was statistically significant. The difference of effect of trial drug on functional parameters between groups were statistically significant. CONCLUSION: The study revealed that, though both the trial drugs; Vatari Guggulu and Seetarama Vati are effective in the management of Amavata, but clinically Seetarama Vati is comparatively more effective than Vatari Guggulu in the management of Amavata.