Assessment of efficacy of methotrexate with ayurvedic preparation (Singhnad guggul, Rasna saptak kwath, Erand oil) versus methotrexate with placebo in early rheumatoid arthritis: an exploratory double-blind randomized placebo-controlled trial

Rheumatoid arthritis (RA) is a chronic autoimmune disorder affecting small joints. Mortality and morbidity rates are higher due to cardiovascular events. Early, aggressive treatment with disease-modifying anti-rheumatic drugs (DMARDs) is crucial. Ayurveda, an ancient Indian system, is being explored as an adjunct therapy. While some studies support its efficacy, others are inconclusive. Meta-analyses suggest combining Ayurveda with conventional DMARDs improves pain, function, and inflammation. The aim of this study is to investigate whether combination ofmethotrexate with ayurvedic preparation (Singhnad guggul, Rasna sapthak kwath, Erand oil) would result in better efficacy compared to methotrexate alone among patients with early rheumatoid arthritis over 24 weeks. We hypothesize that Methotrexate with Ayurveda will yield better responses and low disease activity at 24 weeks than methotrexate alone.