Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of rheumatoid arthritis

The study by Qian-wen Lv et al 1 found the efficacy of the herb Tripterygium wilfordii Hook F (TwHF) for treatment of rheumatoid arthritis to be non-inferior to that of methotrexate. The duration of that trial was 24 weeks, but rheumatoid arthritis is a chronic disease that requires years of therapy. The authors did not consider adequately the full range of the herb's potential adverse effects, especially for long-term treatment. TwHF has direct effects on the male and female reproductive tracts of humans and laboratory animals.2–4 It causes irregular menses and amenorrhoea, which may be reversible, increased levels of follicle-stimulating and luteinising …