Combination therapy of ginsenoside compound K and methotrexate was efficient in elimination of anaemia and reduction of disease activity in adjuvant-induced arthritis rats

Context Ginsenoside compound K (CK) has anti-inflammatory, immunoregulatory, and myelosuppressive protective effects. Methotrexate (MTX) is widely used in combination therapy for rheumatoid arthritis (RA). Objective To evaluate the effects of combination therapy of CK and MTX on anaemia and anti-arthritis in adjuvant-induced arthritis (AA) rats. Materials and methods AA was induced in rats by Complete Freund's adjuvant, and divided into five groups (n = 10): normal, AA, CK 80 mg/kg, combination therapy (80 mg/kg CK combined with 0.5 mg/kg MTX), and MTX 0.5 mg/kg. From day 12, CK (once a day for 15 days) or MTX (once every 3 days, five times) were intragastrically administered. Results Combination therapy showed increased haemoglobin to 148.5 +/- 10.1 g/L compared with AA (129.8 +/- 11.7 g/L) and MTX (128.8 +/- 18.4 g/L), and decreased reticulocytes in peripheral blood to 4.9 +/- 1.1% compared with MTX (9.3 +/- 3.3%). In combination therapy group, paw swelling decreased to 5.6 +/- 4.3 mL compared with CK (9.4 +/- 3.9 mL) and MTX (13.5 +/- 7.4 mL), and swollen joint count decreased to 1.4 +/- 0.8 compared with CK (2.1 +/- 1.0) and MTX (2.4 +/- 1.2) at day 24. Combination therapy showed decreased IL-6 to 25.1 +/- 17.2 pg/mL compared with MTX (44.9 +/- 4.8 pg/mL), and decreased IL-17 to 5.8 +/- 3.9 pg/mL compared with MTX (10.7 +/- 4.2 pg/mL). Conclusion The anti-anaemia effect of CK deserves further study, and CK can be a candidate effective drug for combined treatment in RA with anaemia.