Kutkin (also known as picroside or kutki, derived from Picrorhiza kurroa) has a long history of use in traditional Ayurvedic medicine, where it is prescribed for a variety of inflammatory and autoimmune disorders, including rheumatoid arthritis (RA). The traditional rationale for its use in RA centers on its reputed anti-inflammatory and "detoxifying" properties, as described in classical Ayurvedic texts. Kutkin is thought to balance the "Pitta" and "Kapha" doshas, which are associated with inflammation and joint disorders in Ayurveda. However, while there is some preclinical evidence suggesting that Picrorhiza kurroa extracts possess anti-inflammatory and immunomodulatory effects in animal models and in vitro studies, the direct scientific evidence supporting Kutkin's efficacy specifically for rheumatoid arthritis in humans is limited and largely anecdotal. Clinical trials in this area are scarce, and the existing studies are generally of low quality or focus on broader anti-inflammatory effects rather than RA-specific outcomes. Therefore, its use for RA is primarily justified by traditional practice rather than robust scientific validation.