A placebo‐controlled evaluation of butterbur and fexofenadine on objective and subjective outcomes in perennial allergic rhinitis

Lee, D. K. C.; Gray, Robert D.; Robb, Fiona; Fujihara, Satomi; Lipworth, Brian J.

doi:10.1111/j.1365-2222.2004.1903.x

Cited by 43 publications

(34 citation statements)

References 17 publications

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“…58 Complete stereochemical characterization may become necessary as part of further pharmacological characterization of these compounds from the medicinal plant Petasites hybridus. [68][69][70] This work may become the basis for further molecular mechanics and DFT calculations in the field of eremophilane research comparable to those, which have been extensively applied in phytochemistry of other sesquiterpene classes in the context of conformational analysis; for example, theoretical studies on potentially active centers and molecular interactions; simulation of the enzymebinding by inhibitors; elucidation of structure-activity relationships; and determination of the absolute configuration and calculation of CD spectra. [71][72][73][74][75][76][77][78][79][80] A further important result of the present investigation is the observation of a concentration dependence of both CD and NMR spectra of certain derivatives, e.g., 1, in certain solvents (methanol).…”

Section: Discussionmentioning

confidence: 98%

Absolute configuration of eremophilane sesquiterpenes from Petasites hybridus: Comparison of experimental and calculated circular dichroism spectra

Bodensieck¹,

Fabian²,

Kunert³

et al. 2009

Chirality

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In-depth conformational analyses of 10 known eremophilane (= (1S,4aR,7R,8aR)-decahydro-1,8a-dimethyl-7-(1-methylethyl)napththalene) sesquiterpenes, 1-10, from Petasites hybridus were performed with molecular mechanics as well as density functional theory methods. Electronic transition energies and rotational strengths of these eight eremophilane lactones and two petasins were calculated by time-dependent density functional theory (B3PW91/TZVP). The absolute configurations of the constituents could be assigned by comparison of their simulated and experimental circular dichroism (CD) spectra in methanol as (4S,5R,8S,10R) (1, 2), (2R,4S,5R,8S,10R) (3, 4, 5), (2R,4S,5R,8R,9R,10R) (6), (2R,4S,5R,8R,10R) (7, 8), and (3R,4R,5R) (9, 10). Single-crystal X-ray diffraction data of 8beta-hydroxyeremophilanolide ((8S)-8-hydroxyeremophil-7(11)-en-12,8-olide) (1) served as starting point for the theoretical conformational calculations of the 8beta-epimers of the eremophilane lactones. Experimental CD spectra as well as (1)H NMR spectra of compound 1 in methanol were considerably dependent on sample concentration.

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Section: Discussionmentioning

confidence: 98%

Absolute configuration of eremophilane sesquiterpenes from Petasites hybridus: Comparison of experimental and calculated circular dichroism spectra

Bodensieck¹,

Fabian²,

Kunert³

et al. 2009

Chirality

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“…1). Twelve comparative trials did not satisfy the inclusion criteria [34,35,36,37,38,39,40,41,42,43,44,45]. Eight DBPC RCT satisfied the inclusion criteria, but data from 2 were not reported and could not be extracted from the manuscript; the attempt to obtain data directly from the authors failed as well, so graphics were digitized and the SD estimated using an imputation method.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review on the Efficacy of Fexofenadine in Seasonal Allergic Rhinitis: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Clinical Trials

Compalati

Baena-Cagnani

Penagos

et al. 2011

Int Arch Allergy Immunol

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Rationale: Evidence-based medicine represents the effort to highlight the best intervention for patients, clinicians, and policy makers, each from their respective viewpoint, to solve a particular health condition. According to a recently diffused grading system of evidence and recommendations for medical interventions, efficacy and safety represent 2 of the most important features to consider, and data from meta-analyses of randomized controlled clinical trials (RCTs) is the strongest supporting demonstration. Fexofenadine has been used for its efficacy and safety in the treatment of allergic rhinitis (AR) for many years although no meta-analyses supporting its use currently exist. The aim of this study is to assess for the first time the efficacy and safety of fexofenadine in the treatment of AR by means of a meta-analytic analysis of existing RCTs. Since specific evidence should be provided to address recommendations in a pediatric population, the quality of the estimates of this subgroup analysis is assessed. Methods: All double-blind, placebo-controlled randomized trials assessing the efficacy of fexofenadine in AR were searched for in OVID, Medline, and Embase databases up to December 2007. Outcomes were extracted from original articles; when this information was not available, the authors of each trial were contacted. Some graphics were digitalized. The RevMan 5 program was used to perform the analysis. GradePro 3.2.2 was used to assess the quality of the evidence for a pediatric population. Results: Of 2,152 identified articles, 20 were potentially relevant trials. Eight studies satisfied the inclusion criteria and were included in the meta-analysis. The main reasons for exclusion were: unnatural exposure, strong study limitations, an atypical outcome measurement, a design for other outcomes, and not being a placebo-controlled, single-blind study. Seven trials investigated a mixed population of adults and children, 1 trial investigated only children, and 1 trial only adults. In 1,833 patients receiving fexofenadine (1,699 placebo), a significant reduction of the daily reflective total symptom scores (TSS) (SMD –0.42; 95% CI –0.49 to –0.35, p < 0.00001) was found. Positive results were also found for morning instantaneous TSS and individual nasal symptom scores (sneezing, rhinorrhea, itching, and congestion). The safety analysis did not show a significant difference in reported adverse events (AE) between the active and placebo treatment groups (OR = 1.03; 95% CI 0.87–1.22, p = 0.75). A very low heterogeneity between the studies was detected, so a fixed-effects model was used. The mean quality level of the included trials was medium. Specific information for a pediatric population may be assumed with a moderate quality of evidence from only 1 study and with a low quality of evidence, mainly due to indirectness, from the others. Conclusions: This study has 5 major strengths: it represents the first attempt to evaluate the efficacy and safety of fexofenadine in the treatment of AR by means of a meta-analysis...

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“…Modern pharmacological investigations started with Buchers experiments concerning the antispasmodic activity of P. hybridus extracts in isolated guinea pig bowels [2]. Perennial allergic rhinitis and the preventive treatment of migraine are more-recent indications for butterbur extracts [3] [4].…”

mentioning

confidence: 99%

New Eremophilane Sesquiterpenes from a Rhizome Extract of Petasites hybridus

Bodensieck

Kunert

Haslinger

et al. 2007

Helvetica Chimica Acta

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A total of 21 natural products, 1 -21, were isolated from a supercritical CO 2 extract of the rhizomes of Petasites hybridus. Thereby, seven new eremophilane (= (1S,4aR,7R,8aR)-decahydro-1,8a-dimethyl-7-(1-methylethyl)naphthalene) sesquiterpenes, compounds 4, 5, 9, 11, 12, 15, and 17, were identified. The new constituent 9-hydroxyisobakkenolide (15) is the first representative of a group of compounds closely related to the well-known, but rare, bakkenolides. Tsoongianolide B (18) and its degradation product ligularenolide (19) were found as new Petasites constituents as well. The known eremophilanolide 2 was isolated from a plant source for the first time and the oxofuranopetasin 16 was isolated for the first time from the rhizomes of P. hybridus, together with eight other known compounds. The C(8)-epimeric 2-[(tigloyl)oxy]eremophilanolides 3 and 8 could clearly be differentiated. All structures were established by extensive 1D-and 2D-NMR experiments (Tables 1 -3), and confirmed by in-depth GC/MS and HPLC/MS experiments.

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A placebo‐controlled evaluation of butterbur and fexofenadine on objective and subjective outcomes in perennial allergic rhinitis

Abstract: BB and FEX, in comparison to PL, were equally effective in attenuating the nasal response to AMP and in improving nasal symptoms, highlighting a potential role for BB in the treatment of allergic rhinitis.

Cited by 43 publications

References 17 publications

Absolute configuration of eremophilane sesquiterpenes from Petasites hybridus: Comparison of experimental and calculated circular dichroism spectra

Absolute configuration of eremophilane sesquiterpenes from Petasites hybridus: Comparison of experimental and calculated circular dichroism spectra

Systematic Review on the Efficacy of Fexofenadine in Seasonal Allergic Rhinitis: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Clinical Trials

New Eremophilane Sesquiterpenes from a Rhizome Extract of Petasites hybridus

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