earticle

영어

Rheumatoid arthritis (RA) burden is steadily increasing, while current management options remain limited with regards to undesirable effects, and at times, cost. Early evidence shows that molecular hydrogen (H2) therapy significantly reduces RA disease activity, and H2 may become a safe, effective and inexpensive complement to mainstay therapies. H2‘s unique ability to selectively reduce reactive oxygen species may account for why it is succeeding where other antioxidant strategies have failed. The present work aims to critically appraise the available evidence, mainly the first randomized controlled trial in the field, from an evidence based medicine perspective. Demonstrating the quality of the evidence with a systematic approach will help justify and orient future research efforts. The verdict is the following: despite some methodological shortcomings, H2’s benefits in clinically important outcomes are non-negligible and merit further investigations. Mechanistic studies are needed to improve our understanding of H2 at a molecular level, but thanks to H2’s reported safety, well designed and well executed epidemiological initiatives may be ethically viable and may become powerful assets in building the case for its clinical application.