Medicamentos herbolarios utilizados en el manejo de la osteoartrosis: revisión sistemática

Abstract

Introduction. Osteoarthrosis (OA) is the most common rheumatic disease and often results in disability. Its treatment must be comprehensive and consider several aspects. However, the chronic use of anti-inflammatory drugs is associated with severe gastrointestinal, cardiovascular, hematological, and renal adverse reactions. Medicinal plants have been used for centuries in the management of this disease. Objective. This study aimed to carry out a systematic review of the published evidence of 13 plants whose use in OA has been reported. Material and Methods. The search strategy included the following criteria: documents written in English and Spanish, full texts, studies in humans, clinical guidelines, systematic reviews, meta-analysis, randomized clinical studies, observational /epidemiological/ economic studies, reviews, consensus. Particular emphasis was placed on the pharmacological mechanism of action that could justify their use and support the clinical efficacy. The evidence obtained was selected through work questions and level of evidence. Results. Seven hundred and thirty-four articles were found; 346 out of them were chosen to be analyzed. Pro-inflammatory cytokines inhibition, reduction in TNF-α and NF-κB signaling, decrease in osteoclastogenesis, increase in the osteoclasts differentiation, decrease in cyclooxygenase 2 activity, and prostaglandins synthesis are among the mechanisms of action of the studied plants. Conclusions. The several plants reviewed have mechanisms of action that support their use in treating OA and have varying degrees of demonstrated efficacy.