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In Europe, extracts from Harpagophytum procumbens and Salix species are widely used for the treatment of rheumatïc pain. Déclaration of the quantity of active principles helps to optimize treatment success. For both herbal médicinal products, pharmacological and clinical studies hâve proven antirheumafic effectiveness which is superior to placebo and equally effective compared to synthetic médication. Treatment of osteoarthritic and low back pain with Harpagophytum procumbens and Salix extracts is associated with a low incidence ' of adverse events lower than that known from NSAIDs. In terms of quality, safety and efficacy, Harpagophytum procumbens and Salix : extract préparations may fulfill the requirements that characterize synthetic médication. Biopharmaceutical quality of Harpagophytum préparations The monographs of the European Scientific Coopérative on Phytotherapy (ESCOP, 1 996) refer to pharmacopeia définitions of herbal material. Requirements for drug préparations include the eut, dried secondary root tubers that contain at least 2.2% of iridoid glycosides or 1 .2% harpagoside for Harpagophytum procumbens and the dried bark of young branches which should contain not less than 1% of total salicin for Salix species. Harpagophytum préparations For the treatment of painful arthrosis or tendinitis, the Harpagophytum ESCOP Monograph (1 996) recommends 1 .5 3.0 g drug in décoction three times per day or équivalent aqueous or hydroalcoholic extracts. With 9 g crude 1 % drug patients consume 1 00 mg harpagoside (Chrubasik ef ai, 1 996a). An analysis of the Harpagophytum préparations available in Germany 1996 re¬ vealed that the mean harpagoside content of the tablets varied bet¬ ween 1 .5 and 9.3 mg with a daily consumption of harpagoside between 0.2 and 50 mg, respectively (Chrubasik et ai, 1 996b). Tea (aqueous extract) of 9 g crude drug contains a mean of 1 80 mg harpagoside, depending on the harpagoside content of the drug, which varied in the tea drugs 1996 between 1.1 and 3.6% (Chrubasik et ai, 1 996a). Producer extracts with up to 2% harpa¬ goside (Chrubasik et ai, 1 996c) provide tablets with 50 mg har¬ pagoside or less in the daily dosage. A spécial Harpagophytum ex tract, WS 1531* (drug extract ratio 6-9:1, harpagoside enriched, minimum 5%), has recently been used for a dose-finding study (daily dosage of harpagoside 50 and 1 00 mg) (Chrubasik et ai, 1 999). A high drug-extract ratio or a high quantity of extract are not necessarily associated with a high content of active principles (Sporer and Chrubasik, 1 999).

L’efficacité et la sécurité des préparations à base d’extraits d’Harpagophytum et de Salix