Tuesday, June 27, 2017

Deer Antler Velvet in Rheumatoid Arthritis

Someone asked: what is deer antler velvet, how does it work? I ask: does it work at all?
An article in National Geographic News answers the question “What Is It?” like this: “Deer antler velvet is essentially a growth hormone called "insulin-like growth factor 1," or IGF-1.” [1] I could lean back now quoting S. Suzuki’s study as he and his colleagues looked at inhibition of IGF-1 in rheumatoid arthritis.

S. Suzuki and colleagues published [2]: “Inhibition of the insulin-like growth factor system is a potential therapy for rheumatoid arthritis.”  The authors concluded: “These results indicate that aberrant IGF-I and IGFBP-3 production plays a role in abnormal osteoclastic activation and angiogenesis in RA. This work supports future clinical exploration of anti-IGF-IR mAb in drug repositioning as a new treatment for RA.”
So, the inhibition of IGF-1 could be a future treatment. So what about deer antler velvet? Does it harm in rheumatoid arthritis?

WebMD lists other names [3]: Andouiller de Cerf, Antler Velvet, Bois de Cerf, Bois de Cerf Rouge, Bois de Chevreuil, Bois de Velours, Bois de Wapiti, Cervus elaphus, Cervus nippon, Cornu Cervi Parvum, Deer Antler, Deer Antler Velvet, Elk Antler, Elk Antler Velvet etc. pp. And: “Deer velvet contains multiple substances including the female sex hormones estrone and estradiol.”

M. Allen and colleagues published two studies (in 2002 and 2008) and I will show you the results of the more recent study [4]: “A randomized clinical trial of elk velvet antler in rheumatoid arthritis”. The authors examined the effects of elk velvet antler on joint pain and swelling, patient/physician global assessment of disease activity, functional ability, quality of life, blood levels of C-reactive protein, and adverse events in 168 rheumatoid arthritis patients experiencing residual symptoms after standard treatment. “There were no significant differences between groups on any measures.” The authors concluded: “Overall, elk velvet antler does not effectively manage residual symptoms in patients with rheumatoid arthritis.”

A. Gilbey and colleagues published a meta-analysis [5]: “Health benefits of deer and elk velvet antler supplements: a systematic review of randomised controlled studies”. The authors found two studies concerning rheumatoid arthritis, most probably the studies by M. Allen. They concluded: “Claims made for velvet antler supplements do not appear to be based upon rigorous research from human trials, although for osteoarthritis the findings may have some promise.” May have some promise in osteoarthritis isn’t enough.

Let’s have a quick look at the risks of IGF-1 [6]: “Convincing experimental data suggest that the GH/IGF-1 axis plays an important role in cancer development and behaviour. Epidemiological studies have supported an association with cancer, but not with tumour induction per se, although this is a distinction that is important mechanistically but not clinically.”

Does Deer Antler Velvet work in rheumatoid arthritis? No! There hasn’t been any evidence in a randomized controlled trial! Moreover IGF-1 is risky. I wouldn’t counsel my patients to take any of the above mentioned deer antler products.



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