Rheumatic diseases are disorders found in the connective tissue. These disorders can especially be found in the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. There are more than 100 types of rheumatic diseases including rheumatoid arthritis, systemic lupus erythematosus, primary Sjogren's syndrome, osteoarthritis, ankylosing spondylitis, dermatomyositis, fibromyalgia, and scleroderma. These rheumatic diseases impose remarkable burdens globally. They can affect the musculoskeletal system, as well as affect one or more organs. Therefore, individualized management sometimes is necessary while focusing on the core treatments.

Currently, there is no ideal treatment for most of these rheumatic diseases (e.g., dermatomyositis, scleroderma, primary Sjogren's syndrome, osteoarthritis). Many conventional medications including non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), and biological DMARDs can relieve pain, slow the disease, and prevent further damage. However, some patients have limited responses to current medical strategies. Furthermore, these medications are often associated with one or more kinds of adverse events, such as infection, leukopenia, abnormal liver function, nausea, osteoporosis, peptic ulcer. Chinese herbal medicine (CHM) has a well-documented history of using complex herbal formulations for the treatment of rheumatic diseases. Meanwhile, evidence exists to support that CHM contains numerous bioactive ingredients which are associated with activities against inflammatory mediators, inappropriate immune responses, and cell degeneration. In the clinic, many patients with rheumatic disease use CHM. However, the certainty of current evidence demonstrating the efficacy of CHM in rheumatic diseases remains poor due to methodological flaws. Therefore, it is necessary to provide reliable evidence from well-conducted and adequately reported studies on the effects of CHM in the management of rheumatic diseases to inform decision-making for patients, physicians, and policymakers.

The aim of this Special Issue is to bring together original research and review articles presenting high-quality evidence on the role of Chinese herbal medicine in the management of rheumatic diseases. We especially welcome submission discussing CHM for the treatment of rheumatic diseases, for which the curative effects of conventional medications are limited (e.g., primary Sjogren's syndrome, scleroderma, osteoarthritis, etc.). We are also interested in manuscripts that report the underlying mechanisms as well as the toxicity evaluation of CHM in the prevention and treatment of rheumatic diseases. Systematic reviews are particularly welcome.

Potential topics include but are not limited to the following:

• Safety and efficacy of CHM for the treatment of rheumatic diseases (e.g., rheumatoid arthritis, ankylosing spondylitis, dermatomyositis, fibromyalgia, scleroderma, primary Sjogren's syndrome, osteoarthritis, etc.)
• Quality control of TCM
• In vitro and in vivo study of CHM for the treatment of rheumatic diseases
• Safety and efficacy of integrated CHM and western medicine for the treatment of rheumatic diseases
• Toxicity evaluation of CHM for the treatment of rheumatic diseases
• Omics of CHM for the treatment of rheumatic diseases
• Health economic, cost-effectiveness, and cost-benefit analysis of CHM for the treatment of rheumatic diseases
• Challenges in the use of CHM for the treatment of rheumatic diseases