Systematic Review of Clinical Data with BNO-101 (Sinupret?) in the Treatment of Sinusitis

Abstract

Background: The herbal formula BNO-101 (containing Gentianae radix, Primulae flos, Rumicis herba, Sambuci flos and Verbenae herba; ratio 1:3:3:3:3) has been widely employed as a ‘mucoactive’ agent in Germany for 70 years for the symptoms of respiratory infections. This paper reviews the clinical evidence of BNO-101 in sinusitis. Methods: The systematic search identified 22 studies with BNO-101. Out of these, 6 controlled trials on sinusitis were reassessed according to predefined criteria. 4 trials had almost identical designs and could be examined by meta-analysis. Results: The database comprised approximately 900 patients, mostly young adult males. After 2 weeks of treatment, verum was significantly superior to placebo (2 RCTs, 159 vs. 160 patients, both add-on to antibacterial treatment). The benefit regards the patients’ assessment (‘cured’: verum = 61.1%, placebo = 34.5%), reduction of drain obstruction, headache and radiological signs (all p < 0.05). Comparing BNO-101 to ambroxol (2 RCTs, 151 vs. 150 patients, add-on to antibacterials in 13% of the cases) the patients’ assessment after 2 weeks showed no difference, although it favoured BNO-101 in chronic cases (‘cured’ BNO-101 = 37.1%, ambroxol = 12.5%; p < 0.05). It also favoured BNO-101 concerning pyorrhoea and headache (p < 0.05). No significant differences were reported in 2 open randomised trials vs. N-acetyl-cysteine and vs. the herbal product Myrtol std. Conclusions: BNO-101, combined with standard antibacterial therapy, significantly reduces the acute symptoms and signs of sinusitis. The effects are of the same order of magnitude as observed with other mucoactive agents. In the trials investigated BNO-101 had a favourable risk/benefit ratio, with an incidence of adverse events similar to placebo.

Sinupret Activates CFTR and TMEM16A-Dependent Transepithelial Chloride Transport and Improves Indicators of Mucociliary Clearance

“…The compound is a mixture derived from parts of five plants (elder flowers, primrose flowers with calyx, common sorrel herb, European vervain herb, and gentian root), and has been shown efficacious in reducing acute symptoms and signs of sinusitis [10]. The mechanisms underlying therapeutic benefit of the compound are presently unknown, but are thought to be derived, at least in part, from flavonoid components (flavonol glycosides and free aglycones) of the formulation.…”

The bioflavonoid compound, sinupret, stimulates transepithelial chloride transport in vitro and in vivo

“…In conjunction with antibiotics, the medication has been shown to reduce the acute symptoms and signs of sinusitis. 6 Sinupret contains extracts of five herbs: elder (Sambucus nigra, Caprifoliaceae) flowers, primrose (Primula veris, Primulaceae) flowers with calyx, common sorrel (Rumex acetosa, Polygonaceae) herb, European vervain (Verbena officinalis, Verbenaceae) herb, and gentian (Gentiana lutea, Gentianaceae) root. The effects of this agent are believed to be related to its constituent, naturally occurring bioflavonoids.…”

Verordnungsverhalten anthroposophisch orientierter Ärzte bei akuten Infektionen der oberen Atemwege

“…Dieser inadäquate Einsatz führt durch Medikamentenmehrausgaben, vermeidbare Nebenwirkungen und Resistenzen zu höheren Kosten in den Gesundheitssystemen [12,13]. Komplementärmedizinische Therapierichtungen wie Anthroposophische Medizin, Homöopathie und Phytotherapie bieten für die Behandlung von akuten Atemwegserkrankungen ein breites Sortiment von Therapien und Heilmitteln an, die die Eigenleistung des Organismus anregen und salutogenes Potential aktivieren sollen [14][15][16][17][18]. Neben regulativen und roborierenden Medikamenten können auch symptomatisch wirkende Arzneimittel verordnet werden.…”