A prospective clinical study to evaluate the role of individualized homoeopathic medicine on changes in anti- cyclic citrullinated peptide levels and clinical symptoms in patients with rheumatoid arthritis.

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by inflammatory arthritis and extra-articular involvement. It is a chronic inflammatory disorder typically starts in small peripheral joints, is usually symmetric, and progresses to involve proximal joints and other joints if left untreated. Joint inflammation over time leads to the destruction of the joint with loss of cartilage and bone erosions. It is estimated to affect between 0.5 and 1.0% of the adult population worldwide. The disease is found to affect females more than the male population in the ratio 3:1. It is a multifactorial disease develops due to a combination of genetic and environmental factors. Patients with active RA also experience systemic inflammation associated with a variety of comorbidities, most importantly cardiovascular disease. Timely diagnosis and intervention are essential for preventing complications related to the disease, highlighting the need to identify diagnostic markers that can reliably predict the onset and progression of the condition. Timely diagnosis and intervention are essential for preventing complications related to the disease, highlighting the need to identify diagnostic markers that can reliably predict the onset and progression of the condition. Anti citrullinated protein antibodies (Anti CCP) are autoantibodies that are directed against peptides and proteins that are citrullinated. The detection of anti-cyclic citrullinated peptide (CCP) has emerged as a significant biomarker for the diagnosis of rheumatoid arthritis (RA). This assay exhibits a sensitivity comparable to that of rheumatoid factor (RF), yet it demonstrates superior specificity. Levels of anti CCP serves as a crucial serological marker for RA diagnosis, facilitating early detection, differentiation from other Rheumatoid arthritis forms, and prognostic assessment. An Individualized homoeopathic medicine based on totality of symptoms which include patient’s mental and physical sphere works holistically improving the mental sphere and improve physical signs and symptoms that are evident in homoeopathic cures. A Prospective, Nonrandomized, Open label, Single arm, Clinical Study with a sample size of 38 patients having Rheumatoid arthritis satisfying inclusion and exclusion criteria shall be enrolled for the study. Primary objective is to to find out whether Homoeopathic medicines are useful in changing the levels of Anti-CCP in rheumatoid arthritis at baseline and after a period of 6 months of intervention with individualized Homoeopathic medicines. Secondary objective is to evaluate effect of Homoeopathic medicines using Disease Activity Score 28 (DAS 28) for Rheumatoid arthritis before and after a period of 6 months of intervention. The usual follow up will be done at the interval of 4 weeks and will be recorded in follow up sheets. The descriptive data will be recorded in terms of absolute values, percentage etc. as appropriate. The final outcome will be analyzed as per appropriate statistical methods and inference will be done thereafter. The result will be published in scientific journals.