Artemisia annua

Artemisia annua is an herb containing artemisinin, a sesquiterpene lactone with an unusual endoperoxide bridge that generates reactive oxygen species (ROS) in the presence of iron. This mechanism underlies its WHO-approved antimalarial action—artemisinin-based combination therapies (ACTs) are standard first-line treatment for Plasmodium falciparum malaria. Beyond malaria, human trials show promise for arthritis: an RCT (n=159) found Artemisia extract plus methotrexate/leflunomide improved rheumatoid arthritis outcomes vs standard therapy alone; a placebo-controlled trial (n=42) showed 150mg twice daily reduced osteoarthritis pain/stiffness (WOMAC improvement). Phase I cancer trials have established safety profiles, with artemisinin inducing ferroptosis in iron-rich cancer cells, though human efficacy data remains limited. Not to be used as monotherapy for malaria.

Quick Answer

What it is

Key findings

Grade A: Parasite Clearance
Grade C: Disease Activity (Rheumatoid Arthritis (RA))
Grade C: WOMAC Score (Pain/Stiffness/Function)

Safety

No specific caution or interaction language was detected in the current summary/outcome notes.

ℹ️ Quick Facts: Artemisia annua

Quick Facts: Artemisia annua

Best Evidence:Grade C
Conditions Studied:3
Research Outcomes:5
Grade A Findings:1
Key Effect:Rheumatoid Arthritis (RA)

Outcomes by grade:

3 conditions · 5 outcomes

Detailed Outcomes

Parasite Clearance

WHO-recommended first-line treatment; ACTs achieve >95% cure rates in uncomplicated malaria

50 studies10000 participants

large↑Improves

Disease Activity

Extract (30g/d) + methotrexate/leflunomide more effective than standard therapy alone over 48 weeks

1 study159 participants

moderate↓Improves

WOMAC Score (Pain/Stiffness/Function)

150mg twice daily significantly improved WOMAC total scores vs placebo at 12 weeks (p=0.0159)

1 study42 participants

moderate↓Improves

Long-term Safety/Efficacy

6-month open-label extension showed maintained benefits with continued safety

1 study42 participants

moderate↓Worsens

Symptom Reduction

Sublingual pollen extract (2400 BU/day) reduced symptoms over 32 weeks

1 study40 participants

moderate↓Improves

Evidence by Condition

Best grade per condition (each condition may have multiple outcomes)

CRheumatoid Arthritis (RA)

1 outcome · 1 study

↓Disease ActivityImproves

COsteoarthritis (OA)

1 outcome · 1 study

↓Long-term Safety/EfficacyWorsens

CAllergic Rhinitis (Seasonal Allergies / Hay Fever)

1 outcome · 1 study

↓Symptom ReductionImproves

Research Citations (6)

Artemisinin and Its Derivatives as Potential Anticancer Agents

Molecules (2024)

PMID: 39125055

New clinical application prospects of artemisinin and its derivatives: a scoping review

Infect Dis Poverty (2023)

PMID: 38160997

Artemisinin relieves osteoarthritis by activating mitochondrial autophagy through reducing TNFSF11 expression and inhibiting PI3K/AKT/mTOR signaling in cartilage

Cell Mol Biol Lett (2022)

PMID: 36014407

Effect of Artemisia annua extract on treating active rheumatoid arthritis: A randomized controlled trial

Chin J Integr Med (2017)

PMID: 28035541

A pilot randomized, placebo-controlled clinical trial to investigate the efficacy and safety of an extract of Artemisia annua administered over 12 weeks, for managing pain, stiffness, and functional limitation associated with osteoarthritis of the hip and knee

Clin Rheumatol (2016)

PMID: 26631103

An open-label six-month extension study to investigate the safety and efficacy of an extract of Artemisia annua for managing pain, stiffness and functional limitation associated with osteoarthritis of the hip and knee

N Z Med J (2016)

PMID: 27806033

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