Management of Rheumatoid Arthritis with Individualized Homeopathy: A Prospective, Non-Randomized, Single-Group Interventional Study

Abstract Rheumatoid arthritis (RA) is a chronic inflammatory disorder requiring long-term management. Individualized homeopathy has been proposed as a potential adjunct in integrative care, though clinical evidence is limited. The primary objective of the study was to evaluate the effect of homeopathic medicines in the management of RA using the Disease Activity Score 28 (DAS28). The secondary objective aimed to evaluate the activity profile and quality of life of patients using the American College of Rheumatology 20 (ACR20) response criteria. A multi-center, prospective, non-randomized, single-group interventional RA study included 134 patients diagnosed according to the 2010 ACR/European Alliance of Associations for Rheumatology (EULAR) criteria. Prescriptions were individualized based on classical homeopathic principles. The primary outcome, DAS28, was assessed at baseline and every 3 months for 12 months. Secondary outcomes were ACR20 response criteria measured monthly, covering tender and swollen joint counts, patient and physician global assessments, pain, and disability. The study was registered with the Clinical Trials Registry–India (CTRI/2018/01/011192). Of the 134 enrolled participants, 74 (55.2%) completed the 12-month follow-up for per-protocol analysis, reflecting 44.8% attrition. Statistically significant improvements (p < 0.01) were observed in DAS28 and ACR20 parameters. The baseline DAS28 score (5.03) indicated that the study sample had moderate-to-high RA disease activity, decreasing by 1.26 points at 9 months and by 1.31 points at 12 months, reflecting an improvement over time. ACR20 response included a 40% reduction in tender joints, 90% reduction in swollen joints, and improvements in patient global assessment (77%), physician global assessment (77%), pain (75%), and disability (65%). Symptomatic assessments supported these outcomes. Rhus toxicodendron, Pulsatilla, and Phosphorus were commonly prescribed medicines. Individualized homeopathic treatment resulted in positive outcomes for disease activity and patient-reported outcomes over 12 months, without disease-modifying anti-rheumatic drug use. Findings suggest a potential role for individualized homeopathy in integrative RA management, warranting further investigation in controlled trials.