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What is FACT?
Focus on Alternative and Complementary Therapies is an evidence-based
journal that is a single point of reference for current information
on complementary and alternative medicine (CAM) from around the world.
Current literature is summarised and commented on by members of the
FACT international editorial board, reviewing topics as diverse as
herbal medicines, vitamins, minerals and supplements, homoeopathy,
acupuncture and manipulative therapies, and giving readers a concise
and objective view of the value of such therapies currently available.
FACT also contains news, short reports, focus articles and debates
on CAM.
The full text of FACT is available by
subscription. For further information visit here |
The debate on the use of cannabinoids for relief from multiple
sclerosis symptoms continues with a study outlined in the June issue
of FACT. One
of the major symptoms of MS, spasticity, was studied and secondary measures,
including walking and mobility, neurological disability and general health,
were discussed. The trial was placebo-controlled and patients were administered
a standardised cannabis extract (Cannador), the synthetic active ingredient
of cannabis (Marinol) or a placebo.
The study concludes that the active drugs and placebo had identical effects
on objective spasticity. However, the spasticity perceived by patients
at the end of the trial was improved. Improvements in the secondary measures
included a decrease in the time to walk 10 metres when using the synthetic
drug, and it also improved the patient-rated scales of pain, sleep quality
and spasms.
The study is highlighted in FACT because of its large patient number
and excellent design. Although the researchers found no improvement in
objective spasticity, they recognise that about half of the patients
believed that their spasticity improved: subjective perceptions of spasticity,
rather than objective measurements are arguably more important to the
patient. In conclusion, FACT states that the implications of the study
are relatively clear: that oral cannabinoids do not objectively reduce
the spasticity of MS. Although oral cannabinoids may help relieve subjective
symptoms of MS, the study does not prove the potential benefits of cannabinoid
use in MS patients. It may, however, help direct research in this area
in the future.
American ginseng to prevent influenza
A study into reducing the risk from influenza in the elderly by ginseng
was examined by FACT since these infections take such a serious toll
on the health of older people and because ginseng has previously been
shown to have immunomodulatory activity. Patients received either ginseng
or placebo twice daily. The main outcome of the study was a reported
significant increase in the incidence of influenza, and combined influenza
and respiratory syncytial virus (RSV) in the placebo-treated group.
However, there was no difference found in symptom severity and duration
between the two groups.
FACT notes that it is a meticulous study and that the laboratory confirmation
of cases of influenza during the study was helpful. The significant increase
in incidence of influenza in the placebo group indicates that further
investigation should be conducted, particularly since the number of subjects
who became ill was small. The lack of adverse effects in the trial further
suggests that ginseng is safe for healthy adults but there should be
ongoing scrutiny of this issue. Thus, considering the favourable safety
profile of ginseng and the outcome of this study, the question of ginseng’s
antiviral activity and whether it can be replicated on a larger scale
merits further investigation.
Benefits of cinnamon in type 2 diabetes
Patients were administered cinnamon or placebo for 40 days to investigate
whether cinnamon improves blood levels of glucose and lipids in type
2 diabetes. The study showed that cinnamon administration reduced
fasting glucose levels, triglyceride levels, total cholesterol and low-density
lipoprotein cholesterol levels. High-density lipoprotein cholesterol
levels were not affected. There were no significant changes in the
placebo groups.
FACT states that although the trial does show favourable effects
on glucose and lipid metabolism, the mechanisms of these effects
are not clarified.
Improvements could have been made to enhance the reproducibility, and
therefore merit, of the results. Patient compliance was difficult to
measure, and patients were not asked about their daily diet. It is
not stated whether or not adverse effects were measured. However,
this trial
does have merit since diabetes is a serious condition that affects
a large number of people.
Echinacea for colds in children
A study assessing the efficacy and safety of echinacea for treating
the common cold in children is reported. At the first signs of a cold,
children were administered echinacea or placebo, twice daily. The results
of the study showed no differences between the echinacea and placebo
groups in any of the primary outcomes measured, and the authors conclude
that echinacea was not effective in shortening the duration or decreasing
the severity of upper respiratory tract infections in children.
FACT comments that echinacea does have potential adverse effects, with
increased incidence of rash in the group administered echinacea. Taking
the results of this study, and the adverse effects into account, the
outcomes of this study provide reasonable evidence that children should
not be treated with echinacea since little benefit was found.
However, the results of the study do suggest that the probability of
acquiring a second infection favoured echinacea as a preventive measure.
Previous studies that have shown echinacea’s potential preventive
properties have generally been dismissed due to poor methodology. To
date there are six trials all suggesting the possible benefit of echinacea
as a preventive in the range of 10–15 per cent reduction in the
likelihood of getting a cold. A large modern trial designed to test prevention
may now be warranted. |
The
Pharmaceutical Journal