Treatment of Mild to Moderate Psoriasis with Reli??va, a Mahonia aquifolium Extract???A Double-Blind, Placebo-Controlled Study

Abstract

Psoriasis is usually treated with local and systemic medications that have varying degrees of efficacy and safety profiles. We investigated the efficacy and safety of an alternative treatment from natural sources, Mahonia aquifolium, for the management of mild to moderate psoriasis. Two hundred subjects participated in a randomized, double-blind, placebo-controlled study using either the topical cream Reliéva (a homeopathic product containing a proprietary M. aquifolium extract) or control (placebo) twice a day for 12 weeks. Efficacy and safety were assessed using the Psoriasis Area Severity Index (PASI) and the Quality of Life Index (QLI) questionnaires at different times throughout the 12-week study. The PASI was evaluated by the physician at the beginning (week 0) and end (week 12) of the study. The QLI was assessed by patients at weeks 0, 4, 8, and 12. The results indicate statistically significant (P < 0.05) improvements in PASI and QLI in the Mahonia-treated group, compared with the control group. The side effects reported were infrequent, < 1% and minor; the most frequent side effects were rash, a burning sensation when applying the cream, and clothing stain. These data indicate that Reliéva, a proprietary form of M. aquifolium, is effective and well tolerated in patients with mild to moderate psoriasis.

Poor Reporting of Quality of Life Outcomes in Dermatology Randomized Controlled Clinical Trials

“…The remaining 67 articles satisfied our criteria [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73]. Sixteen concerned atopic dermatitis [7, 13, 14, 18,20,21,22, 26, 29, 31, 42, 46, 56, 66, 67, 70], 1 chronic eczema of the hands [9], 25 psoriasis [10, 17, 27, 30, 33,35,36,37,38,39,...…”

“…The DLQI used in 45% (30/67) of studies was the most frequently used questionnaire. Statistically significant QOL results were reported in only 6 RCTs among the 23 that used a generic questionnaire [7, 37, 55, 57, 63, 72]. …”

“…In 7% (5/67) of the papers, results were presented as means ± SD of the overall scores and for each dimension for each group studied [7, 9, 11, 15, 52]; in 24% (16/67) of the articles, only the overall scores were given [10, 14, 16, 25, 27, 31, 43, 44, 46, 48,54,55,56, 67, 71, 73]; in 39% (26/67) of the articles, only the scores of the difference (before and after treatment), but not overall scores, were provided [8, 17,19,20,21,22,23,24, 29, 30, 33, 35, 37,39,40,41, 47, 49, 53, 57, 60, 62, 63, 65, 70, 72]. The percentage of improvement of the overall score was reported in 15% (10/67) of the studies [18, 26, 36, 38, 42, 51, 58, 59, 64, 68], and 10 gave unclear or no numerical values [12, 13, 28, 32, 34, 45, 50, 61, 66, 69].…”

Evaluation of Wound Healing Potential of Some Indian Herbal Extracts and it’s Formulation in Acne Vulgaris

“…Oregon grape has been shown repeatedly to be helpful in clinical trials for patients with psoriasis, another infl ammatory skin condition. 9 Wound healing is a complex process that can be roughly divided into three overlapping phases of infl ammatory reaction, proliferation, and remodeling. The infl ammatory phase involves vascular responses characterized by blood coagulation and hemostasis as well as cellular events, including infi ltration of leukocytes with varied functions in antimicrobial and cytokine release, which initiates the proliferative response for wound repair.…”

Pharmacological Benefits of Herbal Formulations in the Management of <i>Psoriasis vulgaris<i>

“…Clinical data reported by Bernstein et al (2006), Gulliver and Donsky (2005) and Wiesenauer and Ludtke (1996) show promising results in psoriasis cases for topical formulations (Mahonia aquifolium ointments or creams) compared to placebo or to classic therapeutic options (corticoids, vitamin D derivatives). Preparations of Mahonia were well tolerated, with rare side effects including rash, a burning sensation when applied and staining of clothes.…”