A patient with ankylosing spondylitis (AS) showed clinical improvement in symptoms with alternative and complementary therapies after withdrawal of adalimumab, according to data from a case report published in Complementary Therapies in Clinical Practice.
The report described the case of a 38-year-old woman with a history of uterine leiomyomas who was diagnosed with AS in April 2017. The patient tested positive for human leukocyte antigen (HLA) B27 positive and presented symmetric and bilateral sacroiliitis on imaging. She started adalimumab in August 2017, which showed improvement in levels of inflammatory biomarkers. However, after 9 months of treatment, the patient experiences widespread disease and heat molluscum contagiosum infection. These infections precluded further use of adalimumab; Treatment stopped in September 2018.
The patient was then started on a 60-day course of supplementation, each taken twice daily: Astragalus membrane (150 mg) Vaccinium macrocarbon (250 mg), Optuntia indica ficus (50 mg), superoxide dismutase (100 mg), and caviar phospholipids (75 mg). Within 1 month, the patient experienced resolution of the diffuse skin lesions, although symptoms of ankylosing spondylitis persisted.
An integrated medical approach [of] Use the addon…[with] An anti-inflammatory diet” was discussed with the patient. According to this approach, the patient received a single intramuscular injection of vitamin D3 600,000 IU and a single dose of 400 mg albendazole that was repeated 15 days later. The patient receives a series of supplements once daily – Curcuma Long (500 mg) rhodiola rosary (400 mg) and Omega-3 (3 g) – Self-administered Formulation Contains Selenium (100 mcg), Methylcobalamin (800 mcg), Pyridoxine (100 mg), Zinc (40 mg), Vitamin C (500 mg), and Coenzyme Q10 (100 mg). The patient was also instructed to adhere to an anti-inflammatory diet, which eliminates dairy, gluten, and sugar.
With the help of this regimen, the patient experienced a gradual clinical improvement in AS symptoms. After 2 months, the erythrocyte sedimentation rate (ESR) was found to be significantly reduced compared to pre-treatment levels (23 mm vs 29 mm in the first hour). Levels of C-reactive protein (<0.3 mg/L vs 1.57 mg/L) and alpha-1-acid glycoprotein (46 mg/dL vs 139 mg/dL) were also significantly reduced at 2 months on treatment compared with pretreatment levels. A decrease in thyroid peroxidase antibodies (42.2 units/ml to 15.6 units/ml) was also observed.
Imaging showed significant physical improvements in the sacroiliac joint. Vitamin D, calcium, zinc, and vitamin B12 levels remained at normal levels during treatment, and none reached toxicity. Although the patient reported intermittent episodes of back pain during treatment, inflammatory biomarkers remained at normal levels. Another clinical response was observed when treatment was supplemented with regular physical exercise and cyclobenzaprine 5 mg and 5-hydroxytryptamine 50 mg twice daily.
“This report describes an effective, complementary alternative approach to treating uncommon inflammatory conditions such as AS,” wrote author Dr. Giuselio Freire de Carvalho. “Dietary changes and supplementation were effective in relieving disease-related inflammatory processes,” he noted.
Freire de Carvalho J. Successful treatment of ankylosing spondylitis using complementary and alternative medicine withdrawal from adalimumab therapy. Supplement Ther Clin. Published online October 24, 2021. doi: 10.1016 / j.ctcp.2021.101494