TOPLINE:

In a study, patients with dermatomyositis who used immunostimulatory herbs before symptom onset showed significantly lower rates of myositis-specific, myositis-associated, and antinuclear autoantibodies than those who did not use any herbal supplements.

METHODOLOGY:

• Researchers conducted a retrospective cohort study of 286 patients with dermatomyositis (mean age at disease onset, 49 years; 86% women; 89% White) in a single US center.
• Overall, 36 patients (13%) reported exposure to immunostimulatory herbs before developing dermatomyositis symptoms, including spirulina (61%), elderberry (25%), and ashwagandha (11%), chlorella (8%), echinacea (6%), alfalfa (3%), and tongkat ali (3%). The median time from first herbal use to dermatomyositis onset was 12 months.
• The researchers compared positivity rates of myositis-specific autoantibodies, myositis-associated autoantibodies, and antinuclear autoantibodies between patients with and without herbal exposure.

TAKEAWAY:

• Myositis-specific autoantibody positivity rates were significantly lower in the herbal intake vs non-herbal intake group (22% vs 51%; P = .001).
• Myositis-associated autoantibody positivity rates showed a significant difference between herbal users and nonusers (13% and 32%, respectively; P = .03).
• Antinuclear autoantibody positivity rates were significantly lower in herbal users vs nonusers (40% vs 61%; P = .04).
• Cutaneous Disease Area and Severity Index Activity scores were not significantly different between herbal users and nonusers and did not vary based on autoantibody status among herbal users.

IN PRACTICE:

“Rather than rely only on autoantibody testing, physicians should also consider clinical findings and screen for herbal intake when diagnosing and managing dermatomyositis,” the authors wrote. “Individuals susceptible to developing autoimmune responses should be counseled about the possible risk of herbal use until the pathway is further elucidated,” they added.

SOURCE:

The study was led by Xiwei Yang, Department of Dermatology, University of Pennsylvania, Philadelphia, and was published online on November 5 in JAMA Dermatology.

LIMITATIONS:

The study was performed at a single US academic center and relied on self-reported herb use, which could introduce recall bias; confounding factors such as other dietary practices and infection-related herb use might have influenced results.

DISCLOSURES:

The study was funded by grants from the National Institutes of Health and the Veterans Health Administration Office of Research and Development and Biomedical Research and Development. One author reported receiving grants and consulting fees from multiple pharmaceutical companies including Pfizer, Biogen, Gilead, Corbus Pharmaceuticals, Viela, Amgen, Regeneron, Argenx, CSL Behring, Ventus, q32 Bio, BMS, and Horizon Priovant Pharmaceuticals. No other disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.