Over-the-Counter Anti-inflammatory Supplements for Adjunctive Rheumatoid Arthritis Therapy: A Comprehensive Narrative Review

Rheumatoid arthritis (RA), a prevalent chronic disease, poses significant treatment challenges, including side effects and high costs of conventional therapies. This heightens interest in natural, over-the-counter (OTC) anti-inflammatory supplements as potential adjunctive treatments. Given their roles in mitigating inflammation and oxidative stress, key factors in RA pathogenesis, these supplements could offer valuable therapeutic adjunctive. Our review addresses this emerging area, providing insights into the efficacy and safety of these supplements in RA management. Methods: observational studies, systematic reviews, and meta-analyses on anti-inflammatory supplements in RA over the past 10 years. Relevant articles were reviewed, and data was synthesized. Several supplements demonstrate beneficial anti-inflammatory and antioxidant properties that may improve RA outcomes. Quercetin suppresses inflammatory cytokines and pathways. Green tea polyphenols inhibit mediators like TNF-alpha and IL-6. Curcumin impacts inflammatory cytokines and signaling cascades. Ginger components block enzymes and inflammation pathways. Omega-3 fatty acids modulate immune cell function and cytokine production. While promising, high-quality evidence remains limited, and optimal dosing is uncertain for most supplements. Our review emphasizes the potential of over-the-counter anti-inflammatory supplements as an adjunctive treatment in rheumatoid arthritis. While these supplements, like quercetin, green tea polyphenols, and omega-3 fatty acids, show promising anti-inflammatory and immunomodulatory effects, there are substantial concerns regarding their consistency and quality in the market, unclear interactions with conventional medications, and the lack of standardized dosages. More extensive research, particularly randomized controlled trials, is crucial to establish clear guidelines.