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Plant Science Today (PST)

Research Articles

Vol. 13 No. 3 (2026)

Preliminary efficacy of shallakyadi capsules (Ayurvedic intervention) on post-chikungunya chronic inflammatory rheumatism: Single-arm, open-label clinical trial

DOI
https://doi.org/10.14719/pst.13827
Submitted
25 January 2026
Published
28-09-2026 — Updated on 30-09-2026
Versions

Abstract

Over 40 % of chikungunya (CHIK) patients develop arthritic manifestations resembling amavata disease as described in Ayurveda. Therefore, a clinical trial was planned to establish the efficacy and safety of the Ayurvedic medicine shallakyadi capsules on post-chikungunya chronic inflammatory rheumatism (pCHIK-CIR). A single-centre, open-label, single-arm, clinical trial was conducted on the participants with pCHIK-CIR. A total of 90 participants were treated with shallakyadi capsule, in a dose of two capsules twice daily (each of 500 mg), orally before lunch and dinner for two months. The primary outcomes were disease activity score (DAS-28) and clinical disease activity index (CDAI), while secondary outcomes were health assessment questionnaire (HAQ) and changes in clinical symptoms. Mean changes were calculated using paired t-tests (for continuous data) and the Wilcoxon signed-rank test (ordinal data). A significant improvement was observed in the changes between before and after treatment for the primary and secondary outcomes, viz. DAS-28 (mean difference (MD) ± standard deviation (SD): 1.27 ± 0.74, p < 0.001), CDAI (MD ± SD: 8.85 ± 4.34, p < 0.001), HAQ (MD ± SD: 13.73 ± 5.71, p < 0.001). In contrast, changes in C-reactive protein (CRP) (MD ± SD: 1.17 ± 9.3, p = 0.25) and erythrocyte sedimentation rate (ESR) (MD ± SD: 2.1 ± 13.1, p = 0.14) were statistically insignificant. No adverse drug reactions were observed. Shallakyadi capsule improves disease activity, quality of life and symptomatic relief with no adverse effects in pCHIK-CIR cases during a two-month treatment regimen. The study demonstrates the feasibility and potential of Ayurvedic treatment for post-chikungunya arthritis, underscoring the need for larger, well-designed multicentre trials.

References

  1. 1. Wimalasiri-Yapa BM, Stassen L, Huang X, Hafner LM, Hu W, Devine GJ, et al. Chikungunya virus in Asia-Pacific: A systematic review. Emerg Microbes Infect. 2019;8(1):70–9. https://doi.org/10.1080/22221751.2018.1559708
  2. 2. LaBeaud A, Bashir F, King CH. Measuring the burden of arboviral diseases: The spectrum of morbidity and mortality from four prevalent infections. Popul Health Metr. 2011;9(1). https://doi.org/10.1186/1478-7954-9-1
  3. 3. Thiberville SD, Moyen N, Dupuis-Maguiraga L, Nougairede A, Gould EA, Roques P, et al. Chikungunya fever: Epidemiology, clinical syndrome, pathogenesis and therapy. Antiviral Res. 2013;99(3):345–70. https://doi.org/10.1016/j.antiviral.2013.06.009
  4. 4. Rodríguez-Morales AJ, Cardona-Ospina JA, Fernanda Urbano-Garzón S, Sebastian Hurtado-Zapata J. Prevalence of post-chikungunya infection chronic inflammatory arthritis: A systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2016;68(12):1849–58. https://doi.org/10.1002/acr.22900
  5. 5. Javelle E, Ribera A, Degasne I, Gaüzère B, Marimoutou C, Simon F. Specific management of post-chikungunya rheumatic disorders: A retrospective study of 159 cases in Reunion Island from 2006–2012. PLoS Negl Trop Dis. 2015;9(3):e0003603. https://doi.org/10.1371/journal.pntd.0003603
  6. 6. Bouquillard É, Combe B. A report of 21 cases of rheumatoid arthritis following chikungunya fever: A mean follow-up of two years. Joint Bone Spine. 2009;76(6):654–7. https://doi.org/10.1016/j.jbspin.2009.08.005
  7. 7. Amaral JK, Bingham CO 3rd, Schoen RT. Successful methotrexate treatment of chronic chikungunya arthritis. J Clin Rheumatol. 2020;26(3):119–24. https://doi.org/10.1097/RHU.0000000000000943
  8. 8. Chopra A, Anuradha V, Ghorpade R, Saluja M. Acute chikungunya and persistent musculoskeletal pain following the 2006 Indian epidemic: A 2-year prospective rural community study. Epidemiol Infect. 2012;140(5):842–50. https://doi.org/10.1017/S0950268811001300
  9. 9. Thiberville SD, Boisson V, Gaudart J, Simon F, Flahault A, de Lamballerie X. Chikungunya fever: A clinical and virological investigation of outpatients on Reunion Island, South-West Indian Ocean. PLoS Negl Trop Dis. 2013;7(1):e2004. https://doi.org/10.1371/journal.pntd.0002004
  10. 10. Schilte C, Staikowsky F, Couderc T, Madec Y, Carpentier F, Kassab S, et al. Chikungunya virus-associated long-term arthralgia: A 36-month prospective longitudinal study. PLoS Negl Trop Dis. 2013;7(3):e2137. https://doi.org/10.1371/journal.pntd.0002137
  11. 11. National guidelines for clinical management of chikungunya fever. New Delhi: Ministry of Health and Family Welfare, Government of India; 2023.
  12. 12. Pathak H, Mohan MC, Ravindran V. Chikungunya arthritis. Clin Med (Lond). 2019;19(5):381–5. https://doi.org/10.7861/clinmed.2019-0035
  13. 13. Wang W, Zhou H, Liu L. Side effects of methotrexate therapy for rheumatoid arthritis: A systematic review. Eur J Med Chem. 2018;158:502–16. https://doi.org/10.1016/j.ejmech.2018.09.027
  14. 14. Min HK, Kim SH, Kim HR, Lee SH. Therapeutic utility and adverse effects of biologic disease-modifying anti-rheumatic drugs in inflammatory arthritis. Int J Mol Sci. 2022;23(22):13913. https://doi.org/10.3390/ijms232213913
  15. 15. Abdel Shaheed C, Ferreira GE, Dmitritchenko A, McLachlan AJ, Day RO, Saragiotto B, et al. The efficacy and safety of paracetamol for pain relief: An overview of systematic reviews. Med J Aust. 2021;214(7):324–31. https://doi.org/10.5694/mja2.50992
  16. 16. Jaiswal YS, Williams LL. A glimpse of Ayurveda-the forgotten history and principles of Indian traditional medicine. J Tradit Complement Med. 2016;7(1):50–3. https://doi.org/10.1016/j.jtcme.2016.02.002
  17. 17. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, et al. 2010 rheumatoid arthritis classification criteria: An American College of Rheumatology/European League against rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569–81. https://doi.org/10.1002/art.27584
  18. 18. Fransen J, van Riel PL. The disease activity score and the EULAR response criteria. Clin Exp Rheumatol. 2005;23(5 Suppl 39).
  19. 19. Clinical disease activity index (CDAI) for rheumatoid arthritis: Determines severity of rheumatoid arthritis using only clinical data; 2024.
  20. 20. Chopra A, Saluja M. Validation and usefulness of Indian version (CRD Pune) health assessment questionnaire: Drug trials, community practice and COPCORD Bhigwan population study (1994–2012). Indian J Rheumatol. 2012;7(2)74–82. https://doi.org/10.1016/j.injr.2012.04.009
  21. 21. Shukla RK, Chandil A, Sharma V, Sharma S. Efficacy of Ayurvedic interventions in the management of post-viral arthritis: A case study. J Ayurveda Integr Med Sci. 2024;12:351–7. https://doi.org/10.21760/jaims.9.12.48
  22. 22. Jain J, Narayanan V, Chaturvedi S, Pai S, Sunil S. In vivo evaluation of Withania somnifera-based Indian traditional formulation (Amukkara Choornam) against chikungunya virus-induced morbidity and arthralgia. J Evid Based Integr Med. 2018;23:2156587218757661. https://doi.org/10.1177/2156587218757661
  23. 23. Gupta S, Mishra KP, Kumar B, Singh SB, Ganju L. Andrographolide attenuates complete Freund's adjuvant-induced arthritis via suppression of inflammatory mediators and pro-inflammatory cytokines. J Ethnopharmacol. 2020;261:113022. https://doi.org/10.1016/j.jep.2020.113022
  24. 24. Jain J, Pai S, Sunil S. Standardization of in vitro assays to evaluate the activity of polyherbal Siddha formulations against chikungunya virus infection. Virusdisease. 2018;29(1):32–9. https://doi.org/10.1007/s13337-018-0421-0
  25. 25. Watson H, Nogueira-Hayd RL, Rodrigues-Moreno M, Naveca F, Calusi G, Suchowiecki K, et al. Tender and swollen joint counts are poorly associated with disability in chikungunya arthritis compared to rheumatoid arthritis. Sci Rep. 2021;11(1):18578. https://doi.org/10.1038/s41598-021-98164-9
  26. 26. Online Charak Samhita. Chikitsa Sthana Chapter 3 (Jwara Chikitsa), verse 104: Management of Jwara (different types of fever); 2025.
  27. 27. Srikanta Murthy KR. Madhav Nidanam of Madhavakara. Ch 25, verses 1-12. Varanasi: Chaukhambha Orientalia; 2018. p. 95–6.
  28. 28. Sontakke S, Thawani V, Pimpalkhute S, Kabra P, Babhulkar S, Hingorani L. Open, randomized, controlled clinical trial of Boswellia serrata extract as compared to valdecoxib in osteoarthritis of knee. Indian J Pharmacol. 2007;39(1):27–9. https://doi.org/10.4103/0253-7613.30759
  29. 29. Majeed M, Majeed S, Narayanan NK, Nagabhushanam K. A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee. Phytother Res. 2019;33(5):1457–68. https://doi.org/10.1002/ptr.6338
  30. 30. Srivastava S, Girandola RN. Screening of herbal extracts for rapid effect on activity-induced knee joint discomfort: A randomized and placebo-controlled pilot study. Int J Clin Trials. 2024;11(2):73–83.
  31. https://doi.org/10.18203/2349-3259.ijct20240400
  32. 31. Patel JR, Tripathi P, Sharma V, Chauhan NS, Dixit VK. Phyllanthus amarus: Ethnomedicinal uses, phytochemistry and pharmacology: A review. J Ethnopharmacol. 2011;138(2):286–313. https://doi.org/10.1016/j.jep.2011.09.040
  33. 32. Kumar V, Van Staden J. A review of Swertia chirayita (Gentianaceae) as a traditional medicinal plant. Front Pharmacol. 2016;6:308. https://doi.org/10.3389/fphar.2015.00308
  34. 33. Peterson CT, Denniston K, Chopra D. Therapeutic uses of triphala in Ayurvedic medicine. J Altern Complement Med. 2017;23(8):607–14. https://doi.org/10.1089/acm.2017.0083

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