Willow bark extract STW 33-I in the long-term treatment of outpatients with rheumatic pain mainly osteoarthritis or back pain

Uehleke, Bernhard; Müller, J; Stange, Rainer; Kelber, O; Melzer, Jörg

doi:10.1016/j.phymed.2013.03.023

Cited by 24 publications

(16 citation statements)

References 11 publications

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“…In a 6‐month study by Uehleke et al . (), 436 patients with rheumatic pain due to osteoarthritis or back pain or a combination of both were included using mono or combination therapy with non‐steroidal anti‐inflammatory drugs (NSAIDs) and opioids. The product used was an aqueous willow bark extract (STW 33–1; Proaktiv®, Des Moines, IA USA).…”

Section: Human Clinical Studiesmentioning

confidence: 99%

Efficacy and Safety of White Willow Bark (Salix alba) Extracts

Shara

Stohs

2015

Phytotherapy Research

128

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Willow bark extract has been used for thousands of years as an anti-inflammatory, antipyretic, and analgesic. In spite of its long history of use, relatively few human and animal studies have been published that confirm anecdotal observations. A small number of clinical studies have been conducted that support the use of willow bark extracts in chronic lower back and joint pain and osteoarthritis. Willow bark extracts also are widely used in sports performance and weight loss products presumably because of anti-inflammatory and analgesic activities, although no human studies have been published that specifically and directly document beneficial effects. In recent years, various in vitro and animal studies have demonstrated that the anti-inflammatory activity of willow bark extract is associated with down regulation of the inflammatory mediators tumor necrosis factor-α and nuclear factor-kappa B. Although willow bark extracts are generally standardized to salicin, other ingredients in the extracts including other salicylates as well as polyphenols, and flavonoids may also play prominent roles in the therapeutic actions. Adverse effects appear to be minimal as compared to non-steroidal anti-inflammatory drugs including aspirin. The primary cause for concern may relate to allergic reactions in salicylate-sensitive individuals.

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Section: Human Clinical Studiesmentioning

confidence: 99%

Efficacy and Safety of White Willow Bark (Salix alba) Extracts

Shara

Stohs

2015

Phytotherapy Research

128

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“…In a longer (6 months) observational study on 436 patients with OA and back pain, WBE significantly decreased pain and was well tolerated [73].…”

Section: Salix Spp Fam Salicaceaementioning

confidence: 91%

Phytomedicine in Joint Disorders

Dragoș

Gîlcă

Găman

et al. 2017

Preprint

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Chronic joint inflammatory disorders such as osteoarthritis and rheumatoid arthritis have in common an upsurge of inflammation, and oxidative stress, resulting in progressive histological alterations and disabling symptoms. Currently used conventional medication (ranging from painkillers to biological agents) is potent, but frequently associated with serious, even life-threatening side effects. Used for millennia in traditional herbalism, medicinal plants are a promising alternative, with lower rate of adverse events and an efficiency frequently comparable with that of conventional drugs. Nevertheless, their mechanism of action is in many cases elusive and/or uncertain. Even many of them have been proved effective in studies done in vitro or on animal models, there is a scarcity of human clinical evidence. The purpose of this review is to summarise the available scientific information on these joint-friendly medicinal plants, which have been already tested in human studies: Arnica montana, Boswellia spp., Curcuma spp., Equisetum arvense, Harpagophytum procumbens, Salix spp., Sesamum indicum, Symphytum officinalis, Zingiber officinalis, Panax notoginseng, Whitania somnifera.

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“…Uehleke et al [37] examined the efficacy and safety of willow bark aqueous extract for pain reduction in a pragmatic surveillance study (non-interventional) of 436 patients suffering from MSDs, OA (56.2 %) and back pain (59.9 %). Aqueous WBE (STW 33-I) delivering 120 mg salicin per tablet (with a DER of 16-23 : 1) was ad-ministered (two tablets daily; 240 mg/day salicin) to all patients, who were also allowed co-medication with NSAIDs, mostly diclofenac or ibuprofen, and/or opioids.…”

Section: Musculoskeletal Disordersmentioning

confidence: 99%

“…The most commonly involved SOC was GI, although it is not clear whether a specific treatment group was more affected than others. The authors reported that the outcome was a significant reduction in pain and concluded that the treatment showed good tolerability considering the reduction in pain in relation to the AEs and no relevant drug interactions were observed [37].…”

Section: Musculoskeletal Disordersmentioning

confidence: 99%

“…Taken together, the clinical trials reviewed here [32,[35][36][37][38][39][40] administered WBE that was prepared with 70 % ethanol (DER of 8-14 : 1) and contained approximately 15 % salicin, delivering 120 to 240 mg salicin per day for up to 8 weeks. In most cases, dosage forms were prepared as coated tablets and administered in two divided doses per day.…”

Section: Low Back Painmentioning

confidence: 99%

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United States Pharmacopeia Safety Review of Willow Bark

et al. 2019

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Willow bark (Salix spp.) is an ingredient in some dietary supplements. No serious adverse effects were reported from trials of willow bark extracts delivering 120 – 240 mg salicin (the purported active constituent) daily for up to 8 weeks. All studies involved adults only; none involved special subpopulations such as pregnant or breastfeeding women, or children. The most common adverse effects associated with willow bark are gastrointestinal; a few allergic reactions were also reported. Some publications advise caution when taking willow bark. There is a risk of increased bleeding in vulnerable individuals, salicylates cross the placenta and are eliminated slowly in newborns, some persons are sensitive or allergic to aspirin, and children are at risk of Reye syndrome. Concurrent use with other salicylate-containing medicines increases these risks. Metabolism of 240 mg salicin from willow bark could yield 113 mg of salicylic acid, yet dietary supplement products are not required to be labeled with warnings. In contrast, over-the-counter low-dose aspirin (81 mg strength), which delivers 62 mg salicylic acid, is required by law to include cautions, warnings, and contraindications related to its use in pregnant and nursing women, children, and other vulnerable subpopulations, e.g., those using anticoagulants. In the interest of protecting public health, the United States Pharmacopeia has included a cautionary labeling statement in the United States Pharmacopeia Salix Species monograph as follows: “Dosage forms prepared with this article should bear the following statement: ‘Not for use in children, women who are pregnant or nursing, or by persons with known sensitivity to aspirin.’”

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Willow bark extract STW 33-I in the long-term treatment of outpatients with rheumatic pain mainly osteoarthritis or back pain

Cited by 24 publications

References 11 publications

Efficacy and Safety of White Willow Bark (Salix alba) Extracts

Efficacy and Safety of White Willow Bark (Salix alba) Extracts

Phytomedicine in Joint Disorders

United States Pharmacopeia Safety Review of Willow Bark

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