The Efficacy of Systemic
Enzyme Therapy in the Treatment of Rheumatoid Arthritis
Mazourov V.I., Lila A.M., Klimko N.N.,
Raimuev K.V, Makulova T.G. The Efficacy of Systemic Enzyme Therapy
in the Treatment of Rheumatoid Arthritis. Inter. Journal of
Immunotherapy 1997, Vol. XIII, No. 3/4, pp. 85-91, ISSN 0255-9625.
SO 112 (3-10-2)-(19-04-2)
Medical Academy of Postgraduate Education, Military Medical Academy,
City Rheumatology Center, St. Petersburg, Russia.
Summary
A total of 156 patients with rheumatoid arthritis were enrolled in a
clinical study on safety and efficacy of oral enzyme therapy in a
treatment involving methotrexate and NSAID. One group (n=65)
received methotrexate at a dose of 7.5-10 mg/week and NSAID, while
the second group (n=91) additionally received an oral enzyme
combination preparation (Wobenzym®) in a daily dosage of 15-30
dragées. The group taking enzymes showed superior efficacy in the
therapy with regard to Ritchie Index (improvement: 10.7 points in
group one versus 14.4 points in group two), morning stiffness
(improvement: 49.6 minutes in group one versus 92.0 minutes in group
two), and Lee Index (improvement: 4.2 points in group one versus 5.7
in group two). Laboratory findings showed a decrease in circulating
immune complexes by 30.3 % in group one and 42.2% in group two at
the end of therapy. These beneficial effects of combining oral
enzyme therapy with standard therapy in rheumatoid arthritis are
supported by several findings in the immunological laboratory. The
serum concentrations of interferons were reduced after 6 months of
therapy in the enzyme group to almost normal values as compared to
two to three times higher values in the control group. The
stimulated interferon production was about 70% (IFN-a), and 90%
(IFN-g) increased after treatment in the enzyme group (about 20% and
30% respectively in the control group).
In addition, serum
levels of proinflammatory cytokines (IL-1b and TNF-a) were
significantly more reduced in the enzyme group than in the control
group (control versus enzyme group IL-1b: -4.1 pg/ml versus -10.3
pg/ml; TNF-a: -75.1 pg/ml versus -179.5 pg/ml).
