Ayurveda interventions for Gout: A systematic review

Background: Patients with Gout frequently use Complementary and Alternative Medicines (CAM therapies), which include Ayurveda medications and treatment procedures, and hence it is essential to determine their safety and efficacy/effectiveness. Objectives: A systematic review of the published clinical data in view of the safety and efficacy/effectiveness of Ayurvedic treatment protocols in Gout viz-a-viz Vatarakta. Methods: We searched the PubMed, Cochrane Library (Cochrane Central Register of Controlled Trials: Issue 6 of 12, June 2018), Google Scholar, AYUSH Research Portal (Govt. of India), DHARA, Ancient Science of Life, Shodhganga@INFLIBNET, Online clinical trial registers, and grey literature available from Government Ayurveda College, Trivandrum (Manual search) IPGT & RA, Gujrat Ayurveda University. We excluded abstract-only publications. We could not do a meta-analysis due to the unavailability of relevant studies. Study eligibility criteria: Cases diagnosed as Gout by laboratory findings and/or clinical symptoms, who underwent Ayurvedic treatment/Cases clinically diagnosed as Vatarakta, who underwent Ayurvedic treatment. Participants and interventions and controls: We included participants of either sex satisfying the inclusion criteria who underwent Ayurvedic treatment either Randomized controlled trials (RCTs), Quasi-Experimental Trials, Single group clinical trials, Comparative Clinical Trials (CCTs), and Pragmatic trials. Results: A total of 398 potentially relevant studies were found, and 21studies met the inclusion criteria, among which ten studies were pre-post studies, seven studies were included among Randomized Comparative Clinical Trials, and four were among Comparative clinical trials. Conclusions: and implications of key findings Even though Ayurveda physicians are pragmatically treating/rehabilitating Vatarakta /Gout cases and reported satisfactory results in terms of both safety and efficacy/effectiveness, this review is unable to produce strong valid evidence to prove the efficacy/effectiveness and safety of Ayurveda over Non-Ayurveda interventions or Placebo due to lack of quality and unavailability of published works. So the authors propose well-organized and methodologically sound quality research works in this regard. Systematic review registration number- PROSPERO (CRD42019131198)