Adverse Drug Reactions and Expected Effects to Therapy with Subcutaneous Mistletoe Extracts (Viscum album L.) in Cancer Patients

Abstract

Background. In Europe, mistletoe extracts are widely used as a complementary cancer therapy. We assessed the safety of subcutaneous mistletoe as a conjunctive therapy in cancer patients within an anthroposophic medicine setting in Germany. Methods. A multicentre, observational study was performed within the Network Oncology. Suspected mistletoe adverse drug reactions (ADRs) were described by frequency, causality, severity, and seriousness. Potential risk factors, dose relationships and drug-drug interactions were investigated. Results. Of 1923 cancer patients treated with subcutaneous mistletoe extracts, 283 patients (14.7%) reported 427 expected effects (local reactions <5 cm and increased body temperature <38°C). ADRs were documented in 162 (8.4%) patients who reported a total of 264 events. ADRs were mild (50.8%), moderate (45.1%), or severe (4.2%). All were nonserious. Logistic regression analysis revealed that expected effects were more common in females, while immunoreactivity decreased with increasing age and tumour stage. No risk factors were identified for ADRs. ADR frequency increased as mistletoe dose increased, while fewer ADRs occurred during mistletoe therapy received concurrent with conventional therapies. Conclusion. The results of this study indicate that mistletoe therapy is safe. ADRs were mostly mild to moderate in intensity and appear to be dose-related and explained by the immune-stimulating, pharmacological activity of mistletoe.

Use and Safety of Intratumoral Application of European Mistletoe (Viscum album L) Preparations in Oncology

“…Patients were also more likely to experience multiple ADRs to IT injections. 36,37 These differences were not likely to be a result of differing demographics because there were no significant differences between the 3 treatment groups in terms of age and gender. The elevated frequency of ADRs in response to IT injections compared with SC injections might be explained by the fact that IT injections typically involve administration of much higher doses of mistletoe.…”

“…36,37 It was found that patients were almost 3 times more likely to experience an ADR to IT injections compared with SC injections and 5 times more likely compared with IV infusions (Figure 2). …”

“…35,38 As described previously, documentation officers extract patient information, cancer diagnoses, therapies, adverse events, and disease progress from patient files and record data using the QuaDoSta (Quality management, Documentation and Statistics) software that was developed at Havelhoehe Research Institute. 36,37,39 41 The numbers of ADRs per person were determined, and the management and outcome of ADRs are summarized. To identify potential risks for experiencing an ADR, doses and preparations to which patients experienced ADRs were considered in relation to the doses and preparations to which patients were exposed.…”

“…36,37 pancreatic cancer patients, and 1 patient had liver cancer. Although it is possible that local IT mistletoe-induced inflammation might have irritated the gastrointestinal tract in some patients, it should be noted that pain, nausea, and vomiting can also be symptoms of advanced-stage pancreatic and liver cancers.…”

Effects of Plants on Osteogenic Differentiation and Mineralization of Periodontal Ligament Cells: A Systematic Review

“…Recently, scientists have investigated and determined that bioactive compounds are responsible for the pharmacological effects of medicinal plants, and various phytochemicals have been studied to determine the therapeutic effect of natural products (Chen et al ., ). Studies have shown the effectiveness of medicinal plants in treating diseases such as cancer (Steele et al ., ), Alzheimer's disease (Howes and Houghton, ), chronic obstructive pulmonary disease (Chen et al ., ), diarrhea and cholera secretions (Tradtrantip et al ., ), stomatitis (Gavanji et al ., ), and periodontal disease (Agrawal et al ., ; Gupta et al ., ).…”