Traditional remedies and UC

Friday, 16 December 2011 13:58

Clinical News

Will traditional remedies soon be given to patients with ulcerative colitis ?

Oral or local administration of aminosalicylates (5-ASA) represents the treatment of choice for inducing and maintaining remission in patients with ulcerative colitiis (UC). This class of drugs is effective in 50% of patients and has the advantage of being well tolerated. Nevertheless, in non-responding patients, it is inevitable that powerful immunosuppressive drugs carrying severe risk of possibly dangerous side effects will be proposed. Thus, there exists a clear lack of alternative therapies following failure of 5-ASA treatment. The discovery of new and less aggressive treatments that do not totally inhibit the immune system is therefore a priority. The solution may lie in traditional medicinal remedies. This is what a recent randomized clinical double-blind placebo-controlled study attempted to demonstrate. In patients with UC, it compared the efficacy of 5-ASA with that of a plant extract from the Acanthaceae family, Acanthacea paniculata.This plant is not totally unfamiliar; indeed, it is commonly used as a remedy against the flu in Sweden.  It is part of the panoply of traditional Asian medicine in treatment of fever and certain infections.  Its antipyretic and antinflammatory properties have also been the object of earlier studies.  Surprisingly, trials carried out in patients suffering from moderately active UC demonstrated that an alcohol extract of A. paniculata (called HMPL-004) given orally was as effective as 5-ASA.  After 8 weeks of treatment, patients on 5-ASA and those who had been given HMPL-004 had the same percentage of improvement in symptoms (56% for the HMPL-004 group compared to 59% for the 5-ASA group), the same percentage of clinical remission (complete disappearance: 21% for HMPL-004 compared to 16% for 5-ASA) and the same percentage of improvement in intestinal lesions following endoscopic assessment (74% for HMPL-004 and 71% for 5-ASA). During the course of this trial, the frequency of secondary effects encountered was the same in both groups and remained very low. Results of this study thus clearly demonstrate that therapy derived from traditional medicine possesses the same efficacy as first-line treatment for UC and might be an advantageous alternative to use of 5-ASA. These encouraging results   now need to be confirmed over a longer period than 8 weeks, paying special attention to possible secondary effects of HMPL-004 that may have gone undetected or that do not show up during  short-term treatment.

References :

Randomised clinical trial: herbal extract HMPL-004 in active ulcerative colitis – a double-blind comparison with sustained release mesalazine

T. Tang et al. Alimentary Pharmacology and Therapeutics 2011 ; 33 : 194-202