The effect of purslane supplementation on clinical outcomes, inflammatory and antioxidant markers in patients with rheumatoid arthritis: A parallel double-blinded randomized controlled clinical trial.

2024-12
Phytomedicine : international journal of phytotherapy and phytopharmacology 135
- Ehsan Karimi
- Naheed Aryaeian
- Maassoumeh Akhlaghi
- Jamileh Abolghasemi
- Soudabeh Fallah
- Azadeh Heydarian
- Rahim Rostami
- Mohammad Hadi Bayat
- Mahdi Mahmoudi

PubMed: 39306881
DOI: 10.1016/j.phymed.2024.156006

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 86
Population: 86 patients with RA aged 20-79
Methods: Double-blinded randomized controlled trial, 12 weeks, 500 mg purslane capsule twice daily vs placebo
Blinding: Double-blind
Duration: 12 weeks
Funding: Unclear

Background

Rheumatoid arthritis (RA) is an autoimmune disorder that results in joint dysfunction, inflammation, and increased mortality.

Hypothesis/purpose

The aim of this study was to evaluate the efficacy of purslane supplements on clinical outcomes, as well as inflammation and antioxidant markers in patients with RA.

Study design

A double-blinded randomized controlled clinical trial.

Methods

In this 12-week trial, 86 participants aged between 20 and 79 were divided into two groups. The intervention group (n = 43) received a 500 mg purslane capsule twice a day, while the control group (n = 43) received a placebo capsule of the same shape and dosage.

Results

Seventy-seven patients (37 from the control group and 40 from the purslane group) completed the study. Purslane capsule intake significantly declined visual analog scale (53.38 ± 23.81 vs. 26.25 ± 17.27, p ≤ 0.001), swollen joint count (4.42 ± 3.36 vs. 1.60 ± 1.64, p ≤ 0.001), tender joint count (8.20 ± 5.93 vs. 2.78± 2.15, p ≤ 0.001), High-sensitivity C-reactive protein (p ≤ 0.001), disease activity score (DAS28) (5.17 ± 1.30 vs. 3.48 ± 1.20, p ≤ 0.001) and increased Superoxide dismutase (p = .037), and total antioxidant capacity (p ≤ 0.001) changes. Furthermore, Morning stiffness (p=.002) and Physician Global Assessment (p = .026) significantly decreased in the purslane group compared to the placebo group at the end of the trial. There was a significant decrease in tumor necrosis factor-α (2.885 ± 2.068 vs. 2.330 ± 1.121, p = .046), and erythrocyte sedimentation rate (36.52 ± 20.04 vs. 26.70 ± 22.59, p = .007) levels in the purslane group.

Conclusion

Therefore, supplementation with purslane could lead to improved clinical outcomes, and inflammatory and antioxidant indicators in RA patients.

Research Insights

Portulaca→Increased Antioxidant Enzyme Levels
increased Superoxide dismutase (p = .037)
Effect
Beneficial
Effect size
Small
Dose
500 mg twice a day
Portulaca→Increased Superoxide Dismutase Levels
increased Superoxide dismutase (p = .037)
Effect
Beneficial
Effect size
Small
Dose
500 mg twice daily
Portulaca→Increased Total Serum Antioxidant Capacity
total antioxidant capacity (p ≤ 0.001) changes
Effect
Beneficial
Effect size
Small
Dose
500 mg twice daily
Portulaca→Reduced C-Reactive Protein Levels
High-sensitivity C-reactive protein (p ≤ 0.001)
Effect
Beneficial
Effect size
Small
Dose
500 mg twice daily
Portulaca→Reduced Disease Activity Score
disease activity score (DAS28) (5.17 ± 1.30 vs. 3.48 ± 1.20, p ≤ 0.001)
Effect
Beneficial
Effect size
Moderate
Dose
500 mg twice daily
Portulaca→Reduced Erythrocyte Sedimentation Rate
erythrocyte sedimentation rate (36.52 ± 20.04 vs. 26.70 ± 22.59, p = .007) levels in the purslane group
Effect
Beneficial
Effect size
Moderate
Dose
500 mg twice daily
Portulaca→Reduced Morning Stiffness
Morning stiffness (p=.002) ... significantly decreased in the purslane group compared to the placebo group at the end of the trial
Effect
Beneficial
Effect size
Small
Dose
500 mg twice daily
Portulaca→Reduced Pain
Purslane capsule intake significantly declined visual analog scale (53.38 ± 23.81 vs. 26.25 ± 17.27, p ≤ 0.001)
Effect
Beneficial
Effect size
Large
Dose
500 mg twice a day
Portulaca→Reduced Pain Severity
Purslane capsule intake significantly declined visual analog scale (53.38 ± 23.81 vs. 26.25 ± 17.27, p ≤ 0.001)
Effect
Beneficial
Effect size
Large
Dose
500 mg twice daily
Portulaca→Reduced Physician Global Assessment
Physician Global Assessment (p = .026) significantly decreased in the purslane group compared to the placebo group at the end of the trial.
Effect
Beneficial
Effect size
Small
Dose
500 mg twice a day
Portulaca→Reduced Physician Global Assessment Score
Physician Global Assessment (p = .026) significantly decreased in the purslane group compared to the placebo group at the end of the trial
Effect
Beneficial
Effect size
Small
Dose
500 mg twice daily
Portulaca→Reduced Swollen Joint Count
Purslane capsule intake significantly declined ... swollen joint count (4.42 ± 3.36 vs. 1.60 ± 1.64, p ≤ 0.001)
Effect
Beneficial
Effect size
Large
Dose
500 mg twice daily
Portulaca→Reduced Tender Joint Count
Purslane capsule intake significantly declined ... tender joint count (8.20 ± 5.93 vs. 2.78± 2.15, p ≤ 0.001)
Effect
Beneficial
Effect size
Large
Dose
500 mg twice daily
Portulaca→Reduced Tumor Necrosis Factor Alpha
There was a significant decrease in tumor necrosis factor-α (2.885 ± 2.068 vs. 2.330 ± 1.121, p = .046)
Effect
Beneficial
Effect size
Small
Dose
500 mg twice daily