Pathogenesis and treatment of rheumatoid arthritis with focus on herbal therapeutic approaches (Review)

Rheumatoid arthritis (RA) is a disease in which the body cells are unable to recognize their own components; the condition is termed an autoimmune disorder. It is an inflammatory disease and the lining of the joints is mainly affected, which is known as synovial inflammation. This leads to pain, stiffness, numbness, fever and oedema; due to these symptoms, affected individuals are unable to perform daily tasks. The condition is more commonly reported in females compared to males. Several advancements in diagnostics, clinical tests and allopathic medications have been achieved for the treatment of RA; these include disease‑modifying anti‑rheumatic drugs and non‑steroidal anti‑inflammatory drugs, corticosteroids, which are being used in patients with RA patients. However, although patients experience symptom relief with these treatments, these treatments are also associated with adverse side‑effects. Therefore, in an aim to identify safer treatments with minimal or no side‑effects, focus is being placed towards ayurvedic and herbal medicines. Some plants have been reported to possess anti‑inflammatory activity, which may be beneficial for the treatment of RA. However, research is still ongoing for a number of the unexplored plants with anti‑inflammatory and anti‑arthritic activity. Examples of such substances include drugs, natural compounds and herbal extracts. In the coming years, it is expected that more herbs will be available commercially for the treatment of RA. With a focus on herbal therapies, the present review discusses the current therapy paradigms and aims to provide a thorough investigation of the pathophysiological factors causing RA. The present review also discusses the integration of phytochemicals into contemporary rheumatology, new developments in herbal pharmacology, and the difficulties in standardization, bioavailability and clinical validation. Further high‑quality clinical trials, mechanistic investigations and translational research are necessary to establish safety profiles, optimise therapeutic formulations and facilitate regulatory approval. The present review attempts to close the gap between modern evidence‑based therapy and traditional herbal knowledge by synthesising recent scientific material, opening the door to a more individualised and integrative approach to treating RA.