Pomegranate extract alleviates disease activity and some blood biomarkers of inflammation and oxidative stress in Rheumatoid Arthritis patients

Eur J Clin Nutr. 2017 Jan;71(1):92-96. doi: 10.1038/ejcn.2016.151. Epub 2016 Aug 31.


Background/objectives: Since the main characteristics of Rheumatoid Arthritis (RA) are joint dysfunction caused by inflammation and serious pain, anti-inflammatory agents may alleviate the clinical symptoms in RA. Pomegranate juice is rich in polyphenolic compounds that possess antioxidant and anti-inflammatory activities. This study aimed to determine the beneficial effects of pomegranate extract (POMx) in RA patients.

Subjects/methods: A total of 55 RA patients were enrolled and randomly allocated to an intervention group (n=30) or a control group (n=25). The intervention group received 2 capsules of 250 mg POMx and the control group 2 capsules of 250 mg cellulose per day for 8 weeks. At the beginning of the study and after 8 weeks, Health Assessment Questionnaire (HAQ) and Disease Activity Score (DAS) 28 were completed and serum concentrations of C-reactive protein (CRP), matrix metalloproteinases 3 (MMP3), malondialdehyde (MDA), glutathione peroxidase (GPx) and erythrocyte sedimentation rate (ESR) were analyzed using standard methods and compared between the two groups.

Results: Compared with the placebo group, POMx supplement significantly reduced the score of DAS28 (P<0.001) which could be related to the decrease in swollen (P<0.001) and tender joints (P=0.001) count, pain intensity (P=0.003) and ESR levels (P= 0.03). POMx consumption also decreased HAQ score (P=0.007) and morning stiffness (P=0.04) and increased GPx concentrations (P<0.001). There were no differences in the change in mean MMP3, CRP and MDA levels between two groups.

Conclusions: POMx alleviates disease activity and improves some blood biomarkers of inflammation and oxidative stress in RA patients.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antioxidants / administration & dosage*
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / drug therapy*
  • Biomarkers / blood
  • Blood Sedimentation / drug effects
  • C-Reactive Protein / analysis
  • Double-Blind Method
  • Female
  • Glutathione Peroxidase / blood
  • Humans
  • Inflammation
  • Lythraceae / chemistry*
  • Male
  • Malondialdehyde / blood
  • Matrix Metalloproteinase 3 / blood
  • Middle Aged
  • Oxidative Stress
  • Phytotherapy / methods*
  • Plant Extracts / administration & dosage*
  • Severity of Illness Index
  • Treatment Outcome


  • Antioxidants
  • Biomarkers
  • Plant Extracts
  • Malondialdehyde
  • C-Reactive Protein
  • Glutathione Peroxidase
  • MMP3 protein, human
  • Matrix Metalloproteinase 3