Echinacea fails?

[Guest guest]

Hi All & Hi Susan,

 

Re the paper: " The Efficacy and Safety of Echinacea in Treating Colds in

Children " by James Taylor MD, Annual Meeting of the Pediatric Academic

Societies, May 4th, 2003, Abstract 1158.

 

Taylor's resullts were disappointing, considering that other workers found

bewnefit in respiratory infections.

 

However, his comment ( " Kids given Echinacea had fewer second and third

colds following treatment as compared to those given the placebo " ) was most

interesting. This may indicate a prevenative efffect of Echinacea via the immune

response. Also, his finding that rashes were more common in Echinacea-

treated children may indicate a reaction of the immune system to " Expel

Pathogens/Toxins " , as in TCM concepts.

 

I have few notes on Echinacea, but what I have says:

 

Zizhuiju; Zichuju; Purple Coneflower Hb; Echinaceae Angustifoliae/Purpureae

Hb (Rx+Caulis+Fl)

 

Actions: Adaptogen; Immunostimulant*; Antiseptic; Antimicrobial; Antiviral;

Anticancer; chemotherapy support; Antiyeast; Antifungal; Prevent

hyaluronidase formation; Vasodilator (peripheral)

 

Dose: 1-2ml of 1:5 45% tincture

 

Indications: Colds & flu; infectious diseases; bacterial & viral

infections~minor;

herpes; candidiasis; psoriasis & eczema; Boils; septicaemia; laryngitis;

pyorrhoea; tonsillitis; tonsillitis; Phlegm; mouthwash; Ext: cuts; etc (as

Antiseptic)

 

Some abstracts:

 

A comparative double blind study of a herbal product Reumaherb in patients

with osteoarthritis. Ferlas-Chlodny, E.; Loniewski, I.; Bialecka, M.; Juzwiak,

S.

Postepy Fitoterapii VOL. 1 NO. 1 2000 PP. 17-22 Oddzial Reumatologii i

Rehabilitacji Samodzielnego Publicznego, Wojewodzkiego Szpitala

Zespolonego, Szczecinie, Poland. In a double blind study with strict selection

criteria, 54 patients (46 females and 8 males) with osteoarthritis of the knee

or

hip were randomly divided into two groups. Group A was treated with a daily

dose of 3x50 mg of diclofenac sodium, Group B received Reumaherb containing

extracts from Echinacea purpurea, Filipendula ulmaria and Harpagophytum

procumbens. Patients were examined and subjected to a series of physical

tests before and after three weeks of treatment. The efficacy of the herbal

product was comparable with the drug treatment. No side effects were reported.

 

Echinacea for upper respiratory infection. Barrett, B.; Vohmann, M.; Calabrese,

C. Journal of Family Practice VOL. 48 NO. 8 1999 PP. 628-635 Department of

Family Medicine, University of Wisconsin-Madison, 777 S Mills, Madison, WI

53715, USA. The evidence regarding the effectiveness of orally ingested

Echinacea extracts in reducing the incidence, severity, or duration of acute

upper respiratory infections (URIs) was reviewed. Information from a wide range

of sources was used as background material. More than 100 articles, books,

and book chapters were reviewed for content and further references. Database

searches, bibliographic reviews, and conversations with experts were carried

out iteratively from January 1997 to February 1999. Selection criteria comprised

published or unpublished reports of all blinded placebo-controlled randomized

trials of any Echinacea formulation used as a treatment or for the prevention of

URIs. Review considerations included randomization, blinding, power, validity

and clinical relevance of outcome measurements, inclusion and exclusion

criteria, indistinguishability of treatment and placebo, and appropriateness of

conclusions for the data presented. Nine treatment trials and 4 prevention

trials

fitting the selection criteria were found. Eight of the treatment trials

reported

generally positive results, and 3 of the prevention trials reported marginal

benefit. Methodologic quality of the majority of the trials was modest. Evidence

from published trials suggests that Echinacea may be beneficial for the early

treatment of acute URIs. The influence of publication bias on those results is

unknown. Echinacea preparations vary widely in composition, and are often

found in combination with other potentially active constituents, making specific

dose recommendations problematic. There is very little evidence supporting the

prolonged use of Echinacea for the prevention of URIs.

Echinaforce® and other Echinacea fresh plant preparations in the treatment of

the common cold. A randomized , placebo controlled , double-blind clinical

trial.

Brinkeborn, R. M.; Shah, D. V.; Degenring, F. H. Phytomedicine VOL. 6 NO. 1

1999 PP. 1-5 Elisabeth Hospital, Wallingatan, Uppsala, Sweden. The aim of

this randomized, double-blind, placebo-controlled study, conducted in Uppsala,

Sweden, between November 1996 and May 1997 was to investigate the efficacy

and safety of different doses and preparations of Echinacea purpurea in the

treatment of the common cold. Of the 559 healthy, adult volunteers recruited to

the study, 246 caught a common cold and took 2 tablets, 3 times daily, of

either Echinaforce (E. purpurea preparation; based on 95% herb and 5% root),

E. purpurea concentrate (same preparation at 7 times higher concentration),

special E. purpurea root preparation (totally different from that of

Echinaforce) or

placebo until they felt healthy again but not for longer than 7 days. The

primary

endpoint was the relative reduction of the complaint index, defined by 12

symptoms assessed during the common cold, according to the doctor's record.

Echinaforce and its concentrated preparation were significantly more effective

than the special Echinacea extract or placebo. All treatments were well

tolerated. Among the Echinacea groups, the frequency of adverse events was

not significantly higher than in the placebo group. Therefore, Echinacea

concentrate as well as Echinaforce represent low-risk and effective alternatives

to the standard symptomatic medicines in the acute treatment of the common

cold.

 

Efficacy and safety of a fixed combination phytomedicine in the treatment of the

common cold (acute viral respiratory tract infection): results of a randomised,

double blind , placebo controlled , multicentre study. Henneicke-von Zepelin,

H.; Hentschel, C.; Schnitker, J.; Kohnen, R.; Kohler, G.; Wustenberg, P. Curr

Med Res Opin VOL. 15 NO. 3 1999 PP. 214-27 Schaper & Brummer GmbH &

Co KG, Salzgitter, Germany. OBJECTIVE: The common cold (acute viral

respiratory tract infection) is one of the most frequent diseases in man, world-

wide. Clinically relevant efficacy should include early improvement of all

symptoms. Results of a clinical trial of a commercially available fixed

combination herbal remedy (Radix echinaceae, Radix baptisiae, Herba thujae)

are reported here. The aim of this study was to verify clinical efficacy shown

in

recent studies under (i) good clinical practice (GCP) quality assurance and (ii)

common situations at family doctors. METHODS: Patients attending one of 15

study centres (practitioners) as a result of an acute common cold were

randomised to the double-blind placebo-controlled study. Three tablets of study

medication were applied t.i.d. for 7 to 9 days. Patients daily documented the

intensity of 18 cold symptoms, as well as the cold overall, using a 10-point

scale and estimated their general well-being using the Welzel-Kohnen colour

scales. Additionally, the severity of illness was assessed by the physician on

days 4 and 8 (CGI-1). The main and confirmatory outcome measure was

expressed as a total efficacy value. This was gauged from the z-standardised

AUC values of the primary endpoints (rhinitis score, bronchitis score, CGI-1 and

general well-being). Adverse events, overall tolerability, vital signs and

laboratory parameters were documented. RESULTS: 263 patients were

included. For safety analysis, all patients were used. 259 patients were

evaluable for primary efficacy analysis (ITT). Results were confirmed analysing

only the 238 valid cases (VCs). The primary efficacy parameters showed the

superiority of the herbal remedy over placebo (p < 0.05). Effect size was 20.6%

of the standard deviation (90% CI: 0.04-41.1%; ITT) and 23.1% (1.7-44.5%;

VC). In relation to the general well-being, the effect size was 33.9% of the

standard deviation (12.5-55.3%; VC). Patients who suffered from at least

moderate symptom intensity at baseline showed response rates (at least 50%

improvement of the global score, day 5) of 55.3% in the herbal remedy group

and 27.3% in the placebo group (p = 0.017; NNT = 3.5). In the subgroup of

patients who started therapy at an early phase of their cold, the efficacy of

the

herbal remedy was most prominent (p = 0.014 for the primary efficacy

parameter). The therapeutic benefit of the herbal remedy had already occurred

on day 2 and reached significance (p < 0.05) on day 4, and continued until the

end of the treatment in the totdl score of symptoms, bronchitis score and

rhinitis score, as well as in the patients' overall rating of the cold

intensity. At

that time, equal levels of improvement were reached three days earlier in the

verum group than in the placebo group. In 26 patients receiving the herbal

remedy and 23 patients receiving placebo, adverse events were reported.

Adverse drug reactions were suspected in two patients in the verum group and

in four patients in the placebo group. Serious adverse events did not occur.

CONCLUSIONS: This study shows that the herbal remedy is effective and safe.

The therapeutic benefit consists of a rapid onset of improvement of cold

symptoms. If patients with colds are able to start the application of the herbal

remedy as soon as practical after the occurrence of the initial symptoms, the

benefit would be expected to increase (e.g. self-medication).

 

A controlled clinical study of Kanjang mixture in the treatment of uncomplicated

upper respiratory tract infections. Thom, E.; Wollan, T. Phytotherapy Research

VOL. 11 NO. 3 1997 PP. 207-210 Medstat Research, P.O. Box 210, 2001

Lillestrom, Norway. A randomized, double-blind placebo-controlled parallel

group clinical trial was performed to investigate the therapeutic effect of

Kanjang

(herbal drug containing Echinacea pallida, Adathoda vasica Adhatoda vasica¨,

Acanthopanax senticosus Eleutherococcus senticosus¨ and Glycyrrhiza

glabra) in the treatment of uncomplicated upper respiratory tract infections

(common cold) in 66 patients (18- to 40-years-old). Medication was taken 3

times per day for a minimum of 5 days or a maximum of 10 days. The primary

outcome measures were: the effect on coughing; quality of sleep; mucus

discharge in the respiratory tract; nasal congestion; and a global evaluation of

the clinical situation and medication tolerability. Assessments were recorded

by patients using visual analogue scales 2, 4 and 10 days after the start of

treatment. Sixty patients completed the study according to the protocol. The

improvement in symptoms following treatment with Kanjang was significantly

better on day 2 and 4 assessments compared with placebo; the day 10 scores

were not significantly different. Tolerability of both treatments was excellent

and

no side-effects were reported in either of the 2 groups. Treatment with Kanjang

significantly eased the symptoms related to uncomplicated upper respiratory

tract infections.

 

Anti-inflammatory and cicatrizing activity of Echinacea pallida Nutt. root

extract.

Speroni, E.; Govoni, P.; Guizzardi, S.; Renzulli, C.; Guerra, M. C. J

Ethnopharmacol VOL. 79 2002 Feb PP. 265-72 Department of Pharmacology,

University of Bologna, Via Irnerio, 48, 40126 Bologna, Italy.

esperoni Among the different species belonging to the

Echinacea family, largely used in traditional medicine, Echinacea pallida,

Echinacea purpurea and Echinacea angustifolia were investigated. These

different species, due to their difficult identification, were commonly confused

in

the past and probably used indifferently for the same therapeutic purposes. In

fact, the three species have in common, some pharmacological activities,

based on the presence of active compounds that act additively and

synergistically. Nevertheless, the composition of each species has slight

variation in the amount of each active component. In particular, echinacoside, a

caffeoyl derivative, is present in E. pallida and only in traces in E.

angustifolia. It

seems to have protective effects on skin connective tissue and to enhance

wound healing. The anti-inflammatory and wound healing activities of

echinacoside, compared with the ones of the total root extract of E. pallida and

E. angustifolia, were examined in rats, after topical application. The tissues

of

the treated animals were evaluated after 24, 48 and 72 h treatment and excised

for histological observation at the end of the experiment. Results confirm the

good anti-inflammatory and wound healing properties of E. pallida and of its

constituent echinacoside, with respect to E. purpurea and control. This activity

probably resides in the antihyaluronidase activity of echinacoside.

 

Benefit-risk assessment of the squeezed sap of the purple coneflower

(Echinacea purpurea) for long-term oral immunostimulation. Parnham, M. J.

Phytomedicine VOL. 3 NO. 1 1996 PP. 95-102 Institute of Pharmacology for

the Natural Sciences, Goethe University Frankfurt, Frankfurt am Main, Bonn,

Germany. A review is presented of the data on the safety of the squeezed sap

of E. purpurea used as an oral immunostimulant. All articles in which the

presence or absence of adverse events of the extract of the flowering coneflower

or its constituents was reported were considered, provided that the dose and

route of administration as well as the patient population were defined. Case

reports and reports of practical experience with the extract of E. purpurea were

not considered in detail. All reported adverse events and unexpected findings

were considered, together with the possible relation to treatment. While

parenteral administration of the squeezed sap of E. purpurea (Echinacin®)

may be associated with symptoms of immunostimulation (shivering, fever,

muscle weakness), these are not generally observed on oral administration.

Adverse events on oral administration for up to 12 weeks are infrequent and

consist mainly of unpleasant taste. In healthy adults, Echinacin® has little

or

no effect on lymphocyte responses, but has been reported to cause transient

lymphopenia in some patients with infections of various aetiologies. This effect

is probably due to redistribution of activated T cells. It is concluded that the

squeezed sap of E. purpurea, widely used in self-medication, is well-tolerated

on long-term oral administration.

 

See also: http://www.symmcorp.com/info/echinacea.htm - Purple cone-flower

plant. Indians of the Great Plains first used this herb as a remedy for

snakebites & other skin wounds. They also applied the root of this plant

directly

to the mouth for toothaches & sore throats. Word of echinacea's healing

properties traveled back to Europe, where it has become one of the most

sought after herbs & one of the better researched.##There is renewed interest

in echinacea today in the United States because of this herb's demonstrated

positive effect on the immune system. Many studies have shown that

echinacea inhibits the enzyme called hyaluronidase, which in turn helps

maintain a natural barrier between healthy tissue & unwanted pathogenic

organisms. Thus, echinacea helps the body maintain its line of defense against

unwanted invaders, & acids in tissue regeneration. Echinacea's antimicrobial

activities are widely demonstrated. In 1972, a study appeared in the Journal of

the Medical Chemistry showing that an echinacea extract inhibited tumor

growth in rats. Echinacea was shown to increase white blood cell

counts..##Several European studies show that echinacea appears to lessen

the severity of colds & flu, & helps speed recovery. Echinacea has also been

used successfully to control candida, an annoying & persistent fungal infection.

In fact, patients who used an antifungal cream & echinacea extract were less

likely to suffer a recurrence than those treated solely with the antifungal

cream.

Other studies show that topical echinacea has been used successfully to

control psoriasis & eczema.##Many of the active compounds in echinacea can

be destroyed during processing. Freeze drying is the most effective way to

preserve this herb's healing properties.##Echinacea has a number of

constituents with immune supporting properties, & they appear to work

synergistically.

 

 

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Susan Wynn wrote:

> PAS: Echinacea Fails to Treat Kids' Colds By Roberta Friedman, PhD

> SEATTLE, WA -- May 7, 2003

 

> The herbal agent Echinacea was not able to cut the severity or

> duration of upper respiratory infections in children, according to

> data reported here May 4th at the 2003 Annual Meeting of the

> Pediatric Academic Societies.

>

> " We cannot recommend Echinacea for upper respiratory infections in

> children at this time " due to the lack of effect in the large,

> randomised, controlled trial, said presenter James Taylor, MD,

> from the department of pediatrics, University of Washington in

> Seattle.

>

> A non-alcohol extract of the plant was tested against a matched

> placebo in 524 children. Three centers participated in the trial,

> including investigators at the National College of Naturopathic

> Medicine and Bastyr University in Kenmore, Washington.

>

> Investigators confirmed 759 colds and obtained 707 completed patient

> log books. Patients and parents reported daily symptoms on a 4-point

> Likert Scale. Times of medication and instances of fever were also

> recorded. Duration of symptoms also comprised part of the primary

> outcome of the trial.

>

> Of the 524 kids, 265 received placebo. Treatment was administered

> twice daily. Mean duration of symptoms for both groups was 9 days,

> and median symptom severity that did not differ between groups.

> Fever lasted 0.81 days for kids taking Echinacea and 0.64 days for

> placebo. The difference was not statistically significant

> (P=0.09). Rash was the only adverse effect evident, with a greater

> frequency among children taking Echinacea (7.1% vs. 2.7%, P=.008).

> " We thought vomiting or stomachache might be higher in the

> Echinacea treated " children instead, said Dr. Taylor. The nature of

> these rashes was not recorded, as they were not anticipated.

>

> Kids given Echinacea had fewer second and third colds following

> treatment as compared to those given the placebo, and " this deserves

> further study, " Dr. Taylor said.

>

> Dr. Taylor said the twice-daily treatment frequency in the study was

> less than some preparations recommend. A limitation of the study is

> the fact that this is a plant extract, with possible species as well

> as regimen differences, Dr. Taylor noted.

>

> [study title: The Efficacy and Safety of Echinacea in Treating Colds

> in Children. Abstract: 1158.]

 

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Best regards,

 

 

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