A Report on Three Recent Clinical Trials Using Mahonia aquifolium 10% Topical Cream and a Review of the Worldwide Clinical Experience With Mahonia aquifolium for the Treatment of Plaque Psoriasis

Abstract

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.

Novel Factors in the Pathogenesis of Psoriasis and Potential Drug Candidates Are Found with Systems Biology Approach

“…A study in 2005 reported significant PASI score reduction of 49.9% by topical theophylline ointment [56]. Mahonia aquafolium extract - consisting of berberine among others - is not classified into ATC classes, but three clinical trials already indicated improvement of psoriasis with this substance [57]. Multiple studies prove efficacy of the terpenoid triptolide in the treatment of psoriasis [58].…”

Traditional herbal remedies that influence cell adhesion molecule activity

“…Mahonia aquifolium is a traditional Western herbal medicine recorded as effectively treating chronic skin diseases, including psoriasis (Felter, 1922;Schar, 1999). Currently phytotherapists still use topical M. aquifolium creams and ointments for psoriasis which has recently been validated by double-blind randomized clinical trials (Bernstein et al, 2006;Gulliver and Donsky, 2005). Research demonstrates that the adhesion of CD4+ T cells to endothelial cells and the resulting migration to skin tissue are necessary in the development of psoriatic skin lesions.…”

Plant extracts for the topical management of psoriasis: a systematic review and meta-analysis

“…[12][13][14][15][16][17][18][19][20][21][22] The 12 studies were conducted in China (3), Germany (2), the U.S.A. After removing duplicates, the remaining 1614 records were screened and the full texts of 1139 articles were retrieved.…”