Rose hip herbal remedy in patients with rheumatoid arthritis – a randomised controlled trial

Objective: To investigate if standardised powder made from rose-hip (Rosa canina) can reduce the symptom score in patients with rheumatoid arthritis. Methods: In a double-blind placebo-controlled trial, patients with rheumatoid arthritis (RA) according to ARA/ACR criteria were randomised to treatment with capsulated rose-hip powder 5 g daily or matching placebo for 6 months at two outpatient clinics in Berlin and Copenhagen. Primary outcome variable was Health Assessment Questionnaire (HAQ) at 6 months, secondary outcome included DAS-28, physician's global evaluation of disease activity, RAQoL, SF-12 and concomitant pain medication. Results: In a total of 89 patients (90% female, mean age 56.6 + 11.3 years, mean disease duration 12.8 +9.6 years) HAQ-DI in the rose-hip group improved by 0.1057 0.346, whereas in the placebo group it worsened by 0.0397 0.253 (p adjusted= 0.032). In the HAQ Patient Pain Scale no significant differences were observed between both groups. In the HAQ Patient Global Scale a trend was seen favouring rose-hip (p= 0.078). The DAS-28 score yielded improvement in the rose-hip group of 0.897 1.32 and in the placebo group of 0.347 1.27 (p =0.056) indicating moderate clinical relevance. The Physicians Global Scale demonstrated more improvement in the rose-hip compared to the placebo group (p =0.012). RAQoL and SF-12 physical score improved significantly in the rose-hip group compared to placebo, whereas SF-12 mental score remained unchanged. Intake of pain medication was not different between the groups. Per-protocol analysis confirmed these results. Conclusion: The results indicate that patients with RA may benefit from additional treatment with rose hip powder.