Effects of hydroalcoholic extract of Berberis integerrima on the clinical signs, hs-CRP, TNFα, and ESR in active rheumatoid arthritis patients

Aim: To evaluate the effects of Barberry (Berberis integerrima) on clinical signs and inflammatory factors in patients with Rheumatoid arthritis (RA). Method: A total of 70 patients with active RA in a double-blind, placebo-controlled clinical trial (IRCT 201409249472N7) were randomly allocated to intervention and control groups. All the patients consumed 1500 mg of barberry extract and 1500 mg Hydroxypropyl methylcellulose (HPMC) each day respectively for three months. Clinical signs and serum levels of high-sensitivity C-reactive protein (hs-CRP), Tumor necrosis factor alpha (TNFα), and erythrocyte sedimentation rate (ESR) were measured before and after the intervention. Results: The results showed that consumption of the extract of Berberis integerrima resulted in a significant decrease in Visual Analog Scale (VAS), morning stiffness, number of tender joints, Disease Activity Score 28 (DAS28), Global Physician Assessment (GPA), serum levels of ESR, TNFα (p < 0.001), and hs-CRP (p < 0.01) in intervention group compared to the control group. Changes in the number of inflamed joints, the necessity for the administration of non-steroidal anti-inflammatory drugs (NSAIDs) (p = 0.02), and glucocorticoids (p < 0.001) were significant only in the intervention group. Conclusion: Barberry can improve clinical signs and inflammatory factors in RA patients and may be useful in their treatment approaches. © 2021 Elsevier Gmb