Aim of research: To evaluate the clinical efficacy and safety of Vatari Guggul, Hingvastak Churna and Brihat Saindhavadi Taila in Amavata (Rheumatoid Arthritis).
Amavata, a poly articular joint disease which is characterised by a group of clinical features like angamarda (body ache), aruchi (anorexia), trisna (thirst), alasya (malaise), gouravam (feeling of heaviness), jwara (fever), apaka (indigestion) and angasunata(inflammation of the body parts)¹ has resemblance with Rheumatoid arthritis. Rheumatoid arthritis is a chronic multisystem disease characterized by persistent inflammatory synovitis, usually, involving peripheral joints in a symmetric distribution. The potential of synovial inflammation to cause cartilage destruction and bone erosions & subsequent changes in joint integrity is the hallmark of the disease. Exact aetiology of Rheumatoid arthritis is unknown. Although recent work has focused on the possible role of super antigens produced by a number of microorganism including staphylococci, streptococci and mycoplasma arthritidis, other possible etiology mechanism in RA include a breakdown in normal self tolerance leading to reactivity to self antigens in the joint such as type-II collagen or loss of immuno regulatory control mechanism resulting in polyclonal ‘T’ cell activation. Super antigens are proteins with the capacity to bind to HLA-DR molecules and particular V segments of the heterodiametric T cell receptor and stimulate specific T cell expressive the V gene products. Of all the potential environmental triggers, the one only clearly associated with the development of RA is cigarette smoking. Rheumatism arthritis effect females in three times more than males it generally occurs in late third or fourth decade of their life spans².
There is no known cure for Rheumatoid arthritis in modern system of medicine, however, the goal of treatment is to reduce joint inflammation and pain, maximise joint function and prevent joint destruction and deformity. Therefore, analgesic and anti inflammatory drugs as first line therapy and Disease Modifying Anti Rheumatic Drugs (DMARD) as second line therapy are used for the management of the disease condition. Whereas, the principle of treatment of Amavata in Ayurveda is etiologically oriented. Since, Agnimandhya - Grahani Dosa has been considered to be the main factor in pathogenesis of this disease, the correction of the gastro-intestinal function is more important to reduce severity and chronicity of the disease.  Owing to the gravity of the situation, a need is felt for searching the safe /effective Ayurvedic formulations to reduce the symptoms. Numbers of clinical trials have been done with single/compound, herbal, herbo-mineral medicines to evaluate their efficacy in the management of the disease. Some of the medicines tried in various institutes of CCRAS and other research institutes are (i) Sunthi Guggulu, (ii) Yogaraj Guggulu, Amavatari Rasa and Maharasnadi Kwatha, (iii) Rasnadi Kwatha, (iv) Musta Churna and Baluka sweda, (v) Aswagandha Churna, (vi) Mahayogaraj Guggulu and Vaiswanara Churna (vii) Simhanaada Guggulu and Brihata Saindhavadi Taila etc. Keeping all these view in consideration and the public health needs, a open clinical trial on the combined effect of 2 classical formulations referred in Ayurvedic Pharmacopeia of India (API)  have been selected to study the clinical efficacy and safety on Amavata Vatari Guggulu(API Part-II; VOL-II) Daily dose/patients- 1 gram (2 tablets of 500mg each) thrice daily , Hingvastaka Churna(API Part-II; VOL-I), Daily dose/patients –1 gm twice daily. Brihat Saindhavadi Taila (API Part-II; VOL-III), Daily dose/patients –20 ml  twice daily for local application for 12 weeks.