Special to The Washington Post RHEUMATOID ARTHRITIS For some, herbal extract may lessen symptoms. THE QUESTION Might an ancient Chinese herbal remedy relieve the painful swollen joints of rheumatoid arthritis? THIS STUDY involved 121 adults with rheumatoid arthritis who had swelling in at least six joints. They were randomly assigned to take an herbal extract made from the peeled root of thunder god vine (lei gong teng, Tripterygium wilfordii Hook F) or the anti-inflammatory drug sulfasalazine (Azulfidine) daily. After nearly six months, about 65 percent of those taking the herb, compared with 33 percent of people taking the drug, reported an improvement of at least 20 percent in such symptoms as pain, swelling and use of their joints. Nearly 60 percent of both groups reported side effects, most often gastrointestinal problems. WHO MAY BE AFFECTED? People with rheumatoid arthritis, especially those who have not found relief through standard drug treatment. Symptoms, which most often afflict the wrist and fingers, can come and go. The disease usually starts in adults younger than 55 and can be short-lived or might last a lifetime. It affects women more than men. CAVEATS About 38 percent of people taking the herb and 59 percent of those taking the drug did not complete the study, usually blaming side effects or unsatisfactory results. Herbal treatment was not compared with methotrexate (Rheumatrex, Trexall), the drug used most often in the United States for rheumatoid arthritis. Long-term effects were not tested. Different preparations of the herb might yield different results. FIND THIS STUDY Aug. 18 issue of Annals of Internal Medicine. LEARN MORE ABOUT rheumatoid arthritis at www.niams.nih.gov. Learn about thunder god vine at www.nccam.nih.gov. The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician. 