Chicken type II collagen (CCII) significantly reduces the symptoms of rheumatoid arthritis (RA) and is associated with fewer adverse events than methotrexate, results from a randomized double-blind controlled trial suggest.
The side effects associated with the use of traditional RA treatments, such as analgesics, immunosuppressants, and cytotoxic drugs, has led to intense research into more specific and better-tolerated treatments.
One promising area of research is immune tolerance. This is "a state of immunologic unresponsiveness induced by oral administration of antigens," explain Wei Wei (Anhui Medical University, Hefei, China) and fellow researchers.
Type II collagen is one such antigen, and is known to ameliorate RA symptoms in animal models by suppressing cartilage degeneration, synovium hyperplasia, and infiltration of inflammatory cells into joints, the team notes in the journal Arthritis Care and Research.
Building on the pre-clinical research, Wei and team compared the efficacy and tolerability of CCII 0.1 mg/day and methotrexate 10 mg/week in 211 individuals with chronic and active RA.
After 24 weeks of treatment with CCII, 68.5% of patients showed disease symptom improvement of at least 20% according to the American College of Rheumatology criteria, and 40.9% showed a 50% improvement.
The degree of improvement was significantly greater among patients given methotrexate than those given CCII, with 83.0% and 57.4% showing an improvement of 20% and 50%, respectively.
However, side effects were significantly milder and less common in patients given CCII than in those given methotrexate.
Specifically, after 24 weeks of treatment, pain, general health, patient-reported efficacy, C-reactive protein level, and erythrocyte sedimentation rate were all significantly improved in those given CCII compared with those given methotrexate.
Similarly, gastrointestinal symptoms - the most commonly observed adverse events - were also significantly less common in patients given CCII than methotrexate, at 7 and 14 patients, respectively.
"The results of our study partly support the mechanism of oral tolerance, an approach that is therapeutically appealing because of the few side effects and easy clinical implementation," say the researchers.
Looking to the future, they say that their data "will provide a basis for more effective application of oral tolerance induction in patients with RA."
Lynn, I heard this many years ago. Nice to see people are trying things again