Psoriasis is usually treated with local and systemic medications that have varying degrees of efficacy and safety profiles. We investigated the efficacy and safety of an alternative treatment from natural sources, Mahonia aquifolium, for the management of mild to moderate psoriasis. Two hundred subjects participated in a randomized, double-blind, placebo-controlled study using either the topical cream Reliéva (a homeopathic product containing a proprietary M. aquifolium extract) or control (placebo) twice a day for 12 weeks. Efficacy and safety were assessed using the Psoriasis Area Severity Index (PASI) and the Quality of Life Index (QLI) questionnaires at different times throughout the 12-week study. The PASI was evaluated by the physician at the beginning (week 0) and end (week 12) of the study. The QLI was assessed by patients at weeks 0, 4, 8, and 12. The results indicate statistically significant (P < 0.05) improvements in PASI and QLI in the Mahonia-treated group, compared with the control group. The side effects reported were infrequent, < 1% and minor; the most frequent side effects were rash, a burning sensation when applying the cream, and clothing stain. These data indicate that Reliéva, a proprietary form of M. aquifolium, is effective and well tolerated in patients with mild to moderate psoriasis.

This monograph summarizes 3 recent clinical trials and the worldwide clinical experience with Mahonia aquifolium in patients with psoriasis. Study 1 was an open-label study to evaluate the safety of Mahonia aquifolium in 39 patients treated for 12 weeks. Assessments made were modified PASI, global assessment, psoriasis history questionnaire, Dermatology Life Quality Index, and Psoriasis Disability Index. The results indicate statistically significant improvement in PASI score and Dermatology Life Quality Index after 4 weeks of treatment. This response continued 1 month after the end of treatment. Study 2 was a clinical trial of 32 patients with mild to moderate bilateral psoriasis treated up to 6 months. One side of the body received Mahonia and the other standard psoriatic treatment (eg, Dovonex cream). The primary outcomes were patient ratings of the Mahonia-treated side alone and the comparison between treatments received on each side of their body. Eighty-four percent of patients rated the Mahonia-treated psoriasis as good to excellent response. When compared with standard treatment, 63% of patients rated Mahonia aquifolium equal to or better than the standard psoriatic treatment. Study 3 was an observational study of 33 patients with mild to moderate bilateral psoriasis treated for 1 month. The results indicate improvement in psoriasis after 1 week of treatment. The side treated with Mahonia did as well or better than the side treated with the vehicle cream. Results from these 3 open-label clinical trials are in agreement with published data that include placebo-controlled studies. Taken together, these clinical studies conducted by several investigators in several countries indicate that Mahonia aquifolium is a safe and effective treatment of patients with mild to moderate psoriasis.

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This clinical study was conducted to determine the efficacy and safety of Reliéva cream in adult patients with atopic dermatitis (eczema). This was an open-label trial in 42 patients with atopic dermatitis treated for 12 weeks with Reliéva cream (a homeopathic product containing Psorberine, a proprietary Mahonia aquifolium extract). Efficacy and safety was assessed using Eczema Area and Severity Index scores and a Subject Reported Evaluation of Treatment. The results showed significant (P < 0.05) improvements with respect to Eczema Area and Severity Index scores by comparison to subjects' baseline scores. In addition, subjects responding to a posttreatment evaluation questionnaire indicated a substantial benefit when rating effectiveness, itching, and appearance as a result of using the study preparation. Reliéva cream appears to be a safe and effective treatment for adult patients with atopic dermatitis (eczema).

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