Homoeopathic Management of Seropositive Rheumatoid Arthritis: An Evidence-Based Case Report

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by progressive joint inflammation, leading to deformities and systemic complications. It is influenced by genetic, epigenetic, and environmental factors. Seropositive RA, identified by the presence of rheumatoid factor (RF) and anti-citrullinated protein antibodies, is associated with a more severe disease course. Conventional treatment includes nonsteroidal anti-inflammatory drugs, glucocorticoids, disease-modifying antirheumatic drugs, biologics, and costimulation blockers. Homoeopathy offers an alternative approach based on individualized remedy selection. A 65-year-old male presented with bilateral pain and swelling in the metacarpophalangeal joints and wrists for 6 months, accompanied by morning stiffness lasting over 30 minutes. Symptoms worsened in cold, damp weather and at night, but improved with movement. The patient experienced physical restlessness, anxiety about his health, and depressive thoughts at night. Seropositive RA, confirmed by positive RF, erythrocyte sedimentation rate, C-reactive protein, and anti-cyclic citrullinated peptide laboratory finding. Following the discontinuation of conventional treatment, individualized homoeopathic management was initiated with Rhus toxicodendron 200C, selected based on symptom totality. The patient demonstrated progressive improvement in joint pain, swelling, and morning stiffness, culminating in seroconversion of the RF. Serial evaluations using the Visual Disease Activity Score calculator confirmed a sustained reduction in disease activity. Causality assessment, performed using the Modified Naranjo Criteria for Homeopathy criteria, supported a probable link between the homoeopathic intervention and the observed clinical outcomes, highlighting the potential role of individualized homoeopathy in the management of seropositive RA.