EFFICACY OF SYSTEMIC ENZYME THERAPY IN THE TREATMENT OF RHEUMATIC DISEASES

Abstract

Rheumatic diseases are characterized by chronic inflammation, immune dysregulation, and progressive tissue damage that often require long-term pharmacotherapy and may be associated with significant adverse effects. Consequently, there is ongoing interest in adjunct therapeutic strategies capable of improving treatment outcomes while maintaining an acceptable safety profile. Systemic enzyme therapy (SET), based on the oral administration of combinations of proteolytic enzymes of plant and animal origin, has been proposed as a supportive therapeutic approach with anti-inflammatory and immunomodulatory properties. This review examines the potential role of systemic enzyme therapy in the comprehensive management of rheumatic diseases, including rheumatoid arthritis, systemic lupus erythematosus, reactive arthritis, and osteoarthritis. Experimental and clinical studies suggest that enzyme preparations may exert anti-inflammatory, anti-edematous, fibrinolytic, and immunomodulatory effects, contributing to the reduction of inflammatory symptoms and improvement of microcirculatory disturbances. Several clinical investigations indicate that the inclusion of systemic enzyme therapy in treatment regimens may enhance tolerability of conventional pharmacotherapy and allow reduction of non-steroidal anti-inflammatory drug dosage without compromising therapeutic efficacy. These findings suggest that systemic enzyme therapy may represent a promising adjunctive approach in rheumatology; however, further well-designed randomized controlled trials are required to clarify its role in modern evidence-based treatment strategies.