Evidence map›Paper›PMID 39900858›Full record

GuidelineZeitschrift fur Rheumatologie2025

[Recommendations of the DGRh Committee on Complementary Medicine and Nutrition on the application of selected phytotherapeutic drugs and herbal medicines in rheumatology].

Gernot Keyßer, Olga Seifert, Inna Frohne, Andreas Michalsen, Alexander Pfeil, Monika Reuß-Borst, Oliver Sander

Abstract readPractice GuidelineEnglish AbstractReview
In one paragraph

Guideline in Zeitschrift fur Rheumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Gernot KeyßerKlinik und Poliklinik für Innere Medizin II, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland. Gernot.Keyszer@uk-halle.de.
Olga SeifertKlinik und Poliklinik für Endokrinologie Nephrologie Rheumatologie, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland.
Inna FrohnePrivatpraxis für Rheumatologie, 45134, Essen, Deutschland.
Andreas MichalsenImmanuel Krankenhaus, 14109, Berlin, Deutschland.
Alexander PfeilKlinik für Innere Medizin III, Universitätsklinikum Jena, 07747, Jena, Deutschland.
Monika Reuß-BorstFacharztpraxis für Innere Medizin, 97708, Bad Bocklet, Deutschland.
Oliver SanderUniversitätsklinikum Düsseldorf, 40225, Düsseldorf, Deutschland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHerbal preparations and phytotherapeutic substances are offered for symptoms and diseases of the rheumatic spectrum and are often intensively advertised in the lay press. The German Society for Rheumatology and Clinical Immunology (DGRh) Committee on Complementary Medicine and Nutrition reviewed the scientific literature on selected over the counter preparations and prescription phytotherapeutic substances and examined the possibilities for their use in rheumatology.

methodsIn an online meeting of the Committee on 8 February 2023 a list of herbal preparations that are frequently used in rheumatology (mostly as self-medication) was drawn up. Each member of the committee then carried out a literature search on one or two substances and summarized the results according to a defined matrix. Research was carried out on borage oil, stinging nettle preparations, cannabis preparations and preparations of dog rose, rosemary, saffron and willow bark. The data on the mixed preparation Phytodolor® (Bayer Vital GmbH, Germany) were also examined. The results were reviewed by a circulation procedure and approved in two further online meetings of the Committee. After review by the DGRh board, the recommendations were transferred to the professional organization's website.

resultsEven though there are reports of anti-inflammatory or immunological effects in vitro and/or in animal models for all the plant substances examined, the evidence for a clinically relevant benefit is sparse. None of the preparations investigated has a therapeutic efficacy that justifies its use in inflammatory joint diseases. Herbal preparations based on saffron and rosemary are generally not recommended. Borage oil from seeds can be taken in standardized form as part of a health-conscious diet but is not expected to have any significant anti-inflammatory effect. Rheumatologists need not advise against Phytodolor® or preparations based on stinging nettle, willow bark or dog rose, which are taken on the patient's initiative for degenerative joint diseases, if a sensible therapy concept is otherwise adhered to. There is insufficient evidence to prescribe medicinal cannabis for inflammatory rheumatic diseases for disease modification or symptomatic therapy. In individual cases, however, its use to reduce chronic pain, particularly neuropathic pain and sleep disorders and to reduce opiate consumption may be justified.

conclusionEven if the herbal preparations presented here must be considered in a differentiated manner for rheumatology practice, the value of phytotherapy for the discipline is low.

Indexed as

Complementary TherapiesPhytotherapyPlant PreparationsRheumatic DiseasesRheumatologyGermanyHumansPlant PreparationsDegenerative joint diseasesMedical plantsNutritional supplementsPhytotherapyRheumatic diseases

Identifiers

PMID39900858
PMCPMC11865164

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.