LETTER TO THE EDITOR
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|Year : 2012 | Volume
| Issue : 3 | Page : 426-
Nalanda College of Pharmacy, Cherlapally, Hyderabad Road, Nalgonda, Andhra Pradesh, India
Nalanda College of Pharmacy, Cherlapally, Hyderabad Road, Nalgonda, Andhra Pradesh
|How to cite this article:|
Banji D. Author's reply.Indian J Pharmacol 2012;44:426-426
|How to cite this URL:|
Banji D. Author's reply. Indian J Pharmacol [serial online] 2012 [cited 2021 Apr 22 ];44:426-426
Available from: https://www.ijp-online.com/text.asp?2012/44/3/426/96358
We thank the authors for their interest in our article and offer the following clarifications to their queries:
In the first place, our aim was to determine the impact of curcumin on FCA-induced arthritis when it is used in combination with methotrexate, and secondly whether this combination could reduce hematological toxicity or not? Therefore, if we segregate the above-said purposes of the study, it may lead to deviation from the main theme of the study; which is exactly what the reader has done. As a therapeutic strategy, methotrexate - a disease modifying antirheumatic therapy - is always incorporated in a dose of 2 mg/kg. Therefore, our study maintained one group treated with the standard dose of methotrexate (2 mg/kg). As prolonged treatment is desirable in rheumatoid arthritis, it has been observed that compliance was low or was discontinued not because it was incapable of suppressing RA, but because of the ensuing adverse effects. We were interested to know whether reduction in dose in the presence of curcumin could offer the same protective measures as seen with methotrexate at 2 mg/kg dose; and if yes, whether this dose could reduce adverse effects. Based on this, we compared the hematological toxicity observed with methotrexate plus curcumin with methotrexate (2 mg/kg) alone. Therefore, in our opinion, comparison of hematological toxicity between the two groups was appropriate.The aim of our experiment was primarily to reduce the dose of methotrexate in the management of rheumatoid arthritis as the dose of 2 mg/kg often leads to noncompliance owing to the adverse effects. Therefore, option 2 of the reader's suggestion does not suit our study. The proposition of keeping one more group with a dose of 1 mg/kg is a valid suggestion which will be taken up in future studies. We would like to bring to the notice of the reader that the combination with curcumin produced significant reduction in paw edema with minimal damage to the hematological system. Therefore, we have not only contributed this response in our discussion section to curcumin but also attributed it to the reduction in the dose of methotrexate. The aim was not purely to reduce hematological toxicity, but alsoto search for an adjuvant which can support the action of methotrexate so that compliance can be improved for a disorder such as RA which requires long-term treatment.Curcumin is not soluble in saline and cannot be used in any of the solvents mentioned above as they are least preferred for parenteral administration. Curcumin is not soluble in gum acacia as well, but can be suspended in gum acacia. We have dispersed curcumin in a saline solution (0.9% NaCl) which, in addition, contained 0.3% sodium carboxy methyl cellulose, and we have termed it as saline control.We have followed standard procedures in our study and they have been further standardized in our laboratory to conform the dose required and duration for complete induction of arthritis. As our treatment was initiated from the ninth day, we considered day 9 values as baseline data. Further, the aim of our study was to assess the curative action of methotrexate plus curcumin and not the preventive response. If we were focusing on the preventive response, it would be absolutely essential for us to reflect the day 0 values. As day 9 was the first day of treatment, large variations cannot be expected within a few hours after initiating the treatment.
We hope that these clarifications have addressed the queries adequately.