This study aimed to evaluate the effects of green tea and supervised exercise training
interventions on improvement of disease activity and bone metabolism markers in rheumatoid
arthritis patients. [Subjects and Methods] One-hundred and twenty subjects who had a mean
age of (60.7 ± 2.53 years) and had been diagnosed with rheumatoid arthritis at least ten
years previously were randomly included in this study. Patients were treated with
infliximab, green tea, or a supervised exercise program for six months. Disease activity
markers as well as antioxidant activity of green tea extracts were estimated before
supplementation using in vitro assays. [Results] Rheumatoid arthritis patients treated
with green tea for 6 months alone or in combination with infliximab or an exercise program
showed significant improvement in disease activity parameters, including C-reactive
protein, and erythrocyte sedimentation rate, swollen and tender joints counts, and
modified Stanford Health Assessment Questionnaire score, along with an increase in serum
levels of bone resorption markers, i.e., deoxypyridinoline, amino-terminal telopeptide of
type 1 collagen, and bone alkaline phosphatase, at 6 months of after initial treatment.
The European League Against Rheumatism and American College of Rheumatology scores
revealed more clinical improvement in the disease activity of rheumatoid arthritis
patients treated with green tea along with exercise compared with rheumatoid arthritis
patients treated with infliximab or exercise combinations. This may have been due to the
higher potential antioxidant activity of green tea (89.6% to 96.5%). [Conclusion] Both
exercise and green tea interventions appeared to be beneficial as nondrug modulates for
rheumatoid arthritis disorders.