Hp extracts probably contain more than one active anti-inflammatory ingredient. Current pharmacological studies indicate that this traditional herbal drug may target pro-inflammatory intracellular pathways and so represents a "modern" antiinflammatory drug. Inflammatory processes are now acknowledged as being ubiquitous in human disease, which broadens the therapeutic potential of anti-inflammatory drugs. Further pharmacological studies of Hp are warranted in order to assess whether Hp has potential beyond the treatment of osteoarthritis. Recent clinical interest in Hp has focused on osteoarthritis, and there is positive evidence of good quality. This is the unanimous conclusion of recently published systematic reviews, which are a key part of establishing evidence-based medicine. More good-quality evidence with improved reporting would enhance the case for Hp becoming a rational option in the treatment of osteoarthritis. Unfortunately, the resources for definitive phase-III trials have been lacking. One can only hope that such resources will soon be made available. Osteoarthritis is a major health problem that urgently requires new therapeutic options . Current therapy targets symptoms and not the disease. Inflammation is now recognised as a key pathophysiological factor in the pathogenesis of osteoarthritis, and anti-inflammatory drugs are considered more than a symptomatic therapy.
The UN named the decade 2001-2010 the "Bone & Joint" Decade. This international initiative (which includes the UN, WHO and several other concerned international and national organisations) aims at improving the treatment and management of diseases of the musculoskeletal system. This initiative indicates that the world has a significant problem with diseases such as osteoarthritis, which is one of the most common musculoskeletal diseases. The incidence of osteoarthritis is increasing as the number of elderly persons in the population increases. Across Europe, North America and Japan, more than 30 million people suffer from this disease, which means that it is more than ten times more common than rheumatoid arthritis, which attracts much more scientific and public attention.
NSAIDS are revered by many as the most successful drugs ever. They have their origin in herbal medicine. As there is an almost drastic need for new anti-inflammatory drugs, these roots should not be forgotten, and the potential of herbal drugs and Hp in particular demands attention.
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