A randomized, double-blind, vehicle-controlled, half-side comparison with a herbal ointment containing Mahonia aquifolium, Viola tricolor and Centella asiatica for the treatment of mild-to-moderate atopic dermatitis

Klövekorn, Winfried; Tepe, Arzuhan Şihoğlu; Danesch, Ulrich

doi:10.5414/cpp45583

Cited by 36 publications

(45 citation statements)

References 16 publications

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“…Mahonia aquifolium demonstrated contrasting results: in an open-label trial in adults, significant improvements were reported in eczema area, severity index scores, and patient satisfaction on the basis of a posttreatment questionnaire, 87 whereas a randomized, double-blind, vehicle-controlled, half-side comparison with an herbal ointment containing M aquifolium, Viola tricolor, and Centella asiatica reported no statistical improvement compared with placebo in either primary skin symptoms or secondary assessment of pruritus, effectiveness, and tolerability. 88 Lyophyllum decastes extracted from Hatakeshimeji mushrooms effectively lowered total skin severity scores and serum IgE levels through its inhibitory action on the T H 2 immune response. 89 Konjac ceramide orally administered favored a shift toward the T H 1 pathway and demonstrated improvements in the Score of Atopic Dermatitis for skin symptoms, decreased skin responses to skin prick testing, and decreased dust mite specific IgE production.…”

Section: Asthmamentioning

confidence: 99%

Complementary and alternative medicine: Herbs, phytochemicals and vitamins and their immunologic effects

Mainardi¹,

Kapoor²,

Bielory³

2009

Journal of Allergy and Clinical Immunology

184

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Section: Asthmamentioning

confidence: 99%

Complementary and alternative medicine: Herbs, phytochemicals and vitamins and their immunologic effects

Mainardi¹,

Kapoor²,

Bielory³

2009

Journal of Allergy and Clinical Immunology

184

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“…Klövekorn and colleagues 436 conducted a placebo-controlled within-person trial in south Germany. A herbal topical cream available in Germany as Ekzevowen derma ® , in the UK as Linderma ® and in the USA as Dermavex ® (Weber & Weber GmbH & Co.) was used as the treatment.…”

Section: Studiesmentioning

confidence: 99%

Scoping systematic review of treatments for eczema

Nankervis

Kim

Delamere

et al. 2016

Programme Grants Appl Res

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BackgroundEczema is a very common chronic inflammatory skin condition.ObjectivesTo update the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) systematic review of treatments for atopic eczema, published in 2000, and to inform health-care professionals, commissioners and patients about key treatment developments and research gaps.Data sourcesElectronic databases including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Skin Group Specialised Register, Latin American and Caribbean Health Sciences Literature (LILACS), Allied and Complementary Medicine Database (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from the end of 2000 to 31 August 2013. Retrieved articles were used to identify further randomised controlled trials (RCTs).Review methodsStudies were filtered according to inclusion criteria and agreed by consensus in cases of uncertainty. Abstracts were excluded and non-English-language papers were screened by international colleagues and data were extracted. Only RCTs of treatments for eczema were included, as other forms of evidence are associated with higher risks of bias. Inclusion criteria for studies included availability of data relevant to the therapeutic management of eczema; mention of randomisation; comparison of two or more treatments; and prospective data collection. Participants of all ages were included. Eczema diagnosis was determined by a clinician or according to published diagnostic criteria. The risk of bias was assessed using the Cochrane Collaboration risk-of-bias tool. We used a standardised approach to summarising the data and the assessment of risk of bias and we made a clear distinction between what the studies found and our own interpretation of study findings.ResultsOf 7198 references screened, 287 new trials were identified spanning 92 treatments. Trial reporting was generally poor (randomisation method: 2% high, 36% low, 62% unclear risk of bias; allocation concealment: 3% high, 15% low, 82% unclear risk of bias; blinding of the intervention: 15% high, 28% low, 57% unclear risk of bias). Only 22 (8%) trials were considered to be at low risk of bias for all three criteria. There was reasonable evidence of benefit for the topical medications tacrolimus, pimecrolimus and various corticosteroids (with tacrolimus superior to pimecrolimus and corticosteroids) for both treatment and flare prevention; oral ciclosporin; oral azathioprine; narrow band ultraviolet B (UVB) light; Atopiclair™ and education. There was reasonable evidence to suggest no clinically useful benefit for twice-daily compared with once-daily topical corticosteroids; corticosteroids containing antibiotics for non-infected eczema; probiotics; evening primrose and borage oil; ion-exchange water softeners; protease inhibitor SRD441 (Serentis Ltd); furfuryl palmitate in emollient; cipamfylline cream; andMycobacterium vaccaevaccine. Additional research evidence is needed for emollients, bath additives, antibacterials, specialist clothing and complementary and alternative therapies. There was no RCT evidence for topical corticosteroid dilution, impregnated bandages, soap avoidance, bathing frequency or allergy testing.LimitationsThe large scope of the review coupled with the heterogeneity of outcomes precluded formal meta-analyses. Our conclusions are still limited by a profusion of small, poorly reported studies.ConclusionsAlthough the evidence base of RCTs has increased considerably since the last NIHR HTA systematic review, the field is still severely hampered by poor design and reporting problems including failure to register trials and declare primary outcomes, small sample size, short follow-up duration and poor reporting of risk of bias. Key areas for further research identified by the review include the optimum use of emollients, bathing frequency, wash products, allergy testing and antiseptic treatments. Perhaps the greatest benefit identified is the use of twice weekly anti-inflammatory treatment to maintain disease remission. More studies need to be conducted in a primary care setting where most people with eczema are seen in the UK. Future studies need to use the same core set of outcomes that capture patient symptoms, clinical signs, quality of life and the chronic nature of the disease.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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“…In more recent randomized, placebo- or active drug-controlled studies on HMs, Xiao-Feng-San, TJ-15, and TJ-17 resulted in significantly improved clinical symptom scores and pruritus scores 6, 15. Furthermore, some individual herbs that benefit AD patients include St John’s wort, licorice, and mahonia 16, 17, 18. The most commonly proposed mechanism of HMs is an anti-inflammatory effect through suppression of the Th2 response and/or modulation of the Th1 response 19 …”

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of combination treatment of herbal medicines and oral antihistamines for atopic dermatitis: a retrospective chart review

Yun

Son

Kim

et al. 2017

Integrative Medicine Research

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BackgroundPatients with atopic dermatitis (AD) exhibit various symptoms, especially itching. Recently, herbal medicines (HMs) are being used in combination with antihistamines for the treatment of AD in Korea. While oral antihistamines can alleviate itching, HMs appear to exert anti-inflammatory effects with minimal side effects. However, there is little evidence regarding the effectiveness and safety of using HMs in combination with antihistamines for AD.MethodsTo observe the effectiveness and safety of combination treatment with HMs and antihistamines, we performed a retrospective chart review of inpatients with AD who received this combination treatment for at least 7 days in a hospital.ResultsOf 163 inpatients, 40 met the inclusion criteria. All patients received HMs three times, and one or two antihistamines, a day after HM intake. A large proportion of patients received first-generation antihistamines. HMs comprised a mixture of an average of 20.69 different herbs in decoction. The mean total, objective, and subjective SCORing Atopic Dermatitis scores showed a significant decrease after combination treatment. Changes in the mean levels of aspartate transaminase, alanine transaminase, blood urea nitrogen, and creatinine were not statistically significant among treatments. There were no adverse events of pseudoaldosteronism or interstitial pneumonia.ConclusionWe observed that the short-term use of HMs in combination with oral antihistamines was safe and effective, with a low risk of adverse reactions. This study was limited by its retrospective design, and prospective studies with long-term follow-up periods are warranted to further elucidate the safety of this combination treatment for AD.

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A randomized, double-blind, vehicle-controlled, half-side comparison with a herbal ointment containing Mahonia aquifolium, Viola tricolor and Centella asiatica for the treatment of mild-to-moderate atopic dermatitis

Cited by 36 publications

References 16 publications

Complementary and alternative medicine: Herbs, phytochemicals and vitamins and their immunologic effects

Complementary and alternative medicine: Herbs, phytochemicals and vitamins and their immunologic effects

Scoping systematic review of treatments for eczema

Effectiveness and safety of combination treatment of herbal medicines and oral antihistamines for atopic dermatitis: a retrospective chart review

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