Pentaherbs Capsule for Atopic Dermatitis in Children

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Hi All,

 

See these abstracts.

 

I have the full text of the first two articles as pdf files and will post them

later

to the files area of the List if Dr. Hon gives permission to do so.

 

Best regards,

.

 

Kam-Lun Ellis Hon, Ting-Fan Leung, Yin Wong, Wai-Kei Christopher Lam,*

De-Qi Bill Guan,+ Kwok-Chiu Ma, Yn-Tz Rita Sung, Tai-Fai Fok and Ping-

Chung Leung+ Departments of Paediatrics and *Chemical Pathology, and

+Institute of , Chinese University of Hong Kong, Prince of

Wales Hospital Shatin, Hong Kong SAR, China. Pentaherbs Capsule as a

Treatment Option for Atopic Dermatitis in Children: An Open-Labeled Case

Series. American Journal of , Vol. 32, No. 6, 941-950.

TCM has been used in patients with atopic dermatitis (AD), but its

therapeutic effects are debatable. We evaluated the clinical and biochemical

effects of a TCM capsule (PentaHerbs capsule) in children with AD. After a

run-in period of 4 weeks, children old enough to manage oral medication

were admitted and their disease severity was evaluated by the SCORing

Atopic Dermatitis (SCORAD) index. Blood was obtained for complete blood

count, total and allergen-specific immunoglobulin E (IgE), biochemical

studies and inflammatory markers of AD severity [serum cutaneous T cell-

attracting chemokine (CTACK), macrophage-derived chemokine (MDC),

thymus and activationregulated chemokine (TARC) and eosinophil cationic

protein (ECP)] prior to, and after 3 months of, TCM use. Three PentaHerbs

capsules twice a day were prescribed for 4 months. Patients were followed

monthly to ensure compliance, and SCORAD scores were obtained at each

visit. Five boys and four girls participated in the study. All patients had

detectable food or inhalant-specific IgE in serum. There was significant

improvement in the overall and component SCORAD scores. There were no

significant differences between the pre- and post-treatment values of the

serum CTACK, MDC, TARC and ECP levels but CTACK showed a

decreasing trend (p = 0.069). No clinical or biochemical evidence of any

adverse drug reaction was observed during the study period. The

PentaHerbs capsules were well tolerated by the children and apparent

beneficial effects were noted clinically. A larger, randomized placebo-

controlled study is required to confirm the efficacy of this formulation for AD.

 

[Note: The PentaHerbs capsule was manufactured, packaged and labeled

by the Industry Development Center, the Hong Kong

Institute of Vocation Education, using GMP standard. The optimal

composition of each herb included was standardized prior to manufacturing.

The powder was formulated into uniform dose capsules under the

supervision of the Clinical Trials Section, Institute of of the

Chinese University of Hong Kong according to established procedures. The

original formula was: Jinyinhua (Fl Lonicerae) 2g, Bohe (Hb Menthae) 1g,

Mudanpi (Cx Moutan) 2g, Cangzhu (Rz Atractylodis) 2g and Huangbai (Cx

Phellodendri) 2g (total 9g of raw herbs daily). The extraction rate from this

raw herb was around 18-20%, which made 6-7 X 250mg capsules. The

dose was 3 capsules (250 mg active herbs each), bid for 16 weeks. The

dose calculation was based on the assumption that patients had to be old

enough to swallow the capsules without difficulty (between 7-12 years of

age). ]

 

Kam-Lun E Hon,1FAAP, Vivian WY Lee,2PharmD, Ting-Fan

Leung,1FRCPCH, MD, Kenneth KC Lee,2PhD, Andrew KW Chan,2BSc,

Tai-Fai Fok,1FRCP, FRCPCH, MD, Ping-Chung Leung,3FRCS, FRACS,

DScCorticosteroids are not Present in a Traditional

Formulation for Atopic Dermatitis in Children Ann Acad Med Singapore

2006;35:xxx-xx 1 Department of Paediatrics 2 School of Pharmacy 3

Institute of The Chinese University of Hong Kong, Prince

of Wales Hospital, Shatin, Hong Kong SAR, China Address for Reprints: Dr

Ellis Hon Kam-lun, Department of Paediatrics, The Chinese University of

Hong Kong, 6/F, Clinical Science Building, Prince of Wales Hospital, Shatin,

Hong Kong SAR, China. Email: ehon. Abstract: TCM has

been used as an alternative in treating children with atopic dermatitis (AD)

but its efficacy and potential side effects are debatable. We recently used a

TCM capsule (PentaHerbs) on 9 children and observed significant

reductions in clinical scores of disease severity. However, there have been

concerns that the therapeutic effects of many forms of TCM are due to the

presence of corticosteroids. The purpose of this study was to evaluate if

common corticosteroids are present in PentaHerbs capsules. Materials and

Methods: PentaHerbs powder was analysed with thin-layer chromatography,

infra-red spectrophotometry and liquid chromatography mass spectrometry.

Results: Hydrocortisone, prednisolone, fludrocortisone and dexamethasone

were not detected in the PentaHerbs capsules. Conclusion: Corticosteroids

are not present in the 5 familiar herbs that were earlier shown to have

efficacy on AD.

 

Hon KL, Leung TF, Ng PC, Lam MC, Kam WY, Wong KY, Lee KC, Sung

YT, Cheng KF, Fok TF, Fung KP, Leung PC. Efficacy and tolerability of a

Chinese herbal medicine concoction for treatment of atopic dermatitis: a

randomized, double-blind, placebo-controlled study. Br J Dermatol. 2007

May 14; [Epub ahead of print].  ehon Department of

Paediatrics, Chinese University of Hong Kong, Shatin, Hong Kong SAR,

China. Background There has been considerable interest in traditional

Chinese herbal medicine (TCHM) as a treatment for atopic dermatitis (AD).

A twice-daily concoction of an ancestral formula containing five herbs has

been found to be beneficial in an open study. Objectives To assess the

efficacy and tolerability of the concoction in children with AD. Methods

Following a 2-week run-in period, children with long-standing moderate-to-

severe AD were randomized to receive a 12-week treatment with twice-daily

dosing of three capsules of either TCHM or placebo. The SCORing of Atopic

Dermatitis (SCORAD) score, Children's Dermatology Life Quality Index

(CDLQI), allergic rhinitis score, and requirement for topical corticosteroid

and oral antihistamine were assessed before and at weeks 4, 8, 12 and 16

after treatment. Adverse events, tolerability, haematological and biochemical

parameters were monitored during the study. Results Eighty-five children

with AD were recruited. Over 12 weeks, the mean SCORAD score fell from

58.3 to 49.7 in the TCHM group (n=42; P=.003) and from 56.9 to 46.9 in the

placebo group (n=43; P=.001). However, there was no significant difference

in the scores at the corresponding time points between the two groups. The

CDLQI in TCHM-treated patients was significantly improved compared with

patients receiving placebo at the end of the 3-month treatment and 4 weeks

after stopping therapy (P=.008 and .059, respectively). The total amount of

topical corticosteroid used was also significantly reduced by one-third in the

TCHM group (P=.024). No serious adverse effects were observed between

the groups. Conclusions The TCHM concoction is efficacious in improving

quality of life and reducing topical corticosteroid use in children with

moderate-to-severe AD. The formulation was palatable and well tolerated.

PMID: 17501956 [PubMed - as supplied by publisher]

 

Best regards,

Best regards,