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| Docs Evaluate Alternative Therapies for Hepatitis C |
| Complementary and Alternative Medicine for Hepatitis Patients |
by John C. Martin
Article
Date: 04-28-04
Docs Evaluate Alternative Therapies for Hepatitis C
A new study evaluating the effectiveness of complementary and alternative therapies for hepatitis C has concluded that they may be "promising" treatments.1
No Definite Conclusions
Complementary therapies have been widely promoted as treatments for
hepatitis C. But their efficacy is controversial, and are not regulated by
the Food and Drug Administration.
A 2002 survey found that, among nearly 1000 patients being treated for various liver diseases at six U.S. clinics, as many as 39 percent had used some form of alternative therapy, mostly herbals and botanicals.2
Consequently, doctors at Peninsula Medical School at the Universities of Exeter and Plymouth in Exeter, England wanted to find out which complementary therapies, if any, might have potential against hepatitis C.
Confirming Study Findings
Joanna Thompson-Coon, Ph.D., and Edzard Ernst, M.D., Ph.D., both of
the School of Complementary Medicine at Peninsula, researched the medical
literature for previous studies testing the efficacy of a range of
alternative therapies for HCV.
"Systematic searches were conducted in six databases, reference lists of all papers were checked for further relevant publications, and information was requested from experts," the two researchers reported.
Coon and Ernst found 27 previously published clinical trials that were relevant, all involving herbal products and supplements. In about half of the trials, patients had received interferon-alfa treatment along with a complementary therapy. But only 11 of these trials were of sufficient quality, making their results plausible. The other trials, Coon and Ernst determined, had questionable outcomes because their designs were also questionable.
Effective CAM
In each of the previous trials, patients had been divided into two groups;
one, taking the active therapy, and the second group (control group)
taking a non-active treatment as a comparison. "Compared with the control
group, significant improvements in virological and/or biochemical response
were seen in trials of vitamin E, thymic extract, zinc, traditional
Chinese medicine, Glycyrrhiza glabra, and oxymatrine," the researchers
concluded.
Vitamin E
Vitamin E has been shown to reduce the ill-effects of oxidative
stress in the livers of people with hepatitis C.3 In fact, this
vitamin is known as an antioxidant, nutrients that act to protect your
cells against the effects of free radicals, molecules that are damaging
by-products of the body's metabolism. Free radicals can cause cell damage
that can contribute to disease.4
Thymic Extract
Thymic extract is made from the thymus of cows. The thymus has an
important role in immune function by enticing white blood cells to become
T cells that recognize particular foreign invaders in the body, and become
part of the body's defenses against infection.5
While one study at the University of Alabama found thymic extract monotherapy was not effective against hepatitis C,6 other studies using thymosin (a hormone of the thymus) combined with interferon-alfa as combination treatment for HCV was effective at reducing viral load.7 And one pilot study showed this combination treatment was more effective than interferon-alfa monotherapy.8
Zinc
Zinc, an antioxidant like vitamin E, has been shown to enhance patients'
responses to interferon therapy.9,10
Chinese Medicine
Traditional Chinese medicine has involved the use of schisandra, a plant
whose effects have been studied mostly in animals. The studies have
suggested that fruit from the plant can protect the liver, benefits liver
enzymes, and provides an antioxidant effect.11,12 But other
herbs used in this category have also been implicated as a possible
treatment.
Glycyrrhiza glabra is also known as a licorice plant. Its dried root contains a potentially therapeutic substance known as glycyrrhizin, and has been used for centuries as part of traditional Chinese medicine.13
While some previous research has only involved lab studies, it has suggested that glycyrrhizin may have antiviral properties.14 But a review of previous clinical trials found glycyrrhizin has the potential to reduce long-term complications in chronic hepatitis C in patients who have not responded previously to interferon.15
And a study in 1997 suggested glycyrrhizin may help prevent liver cancer in chronic HCV patients.16
Oxymatrine
Oxymatrine is a substance found in sophora roots. In a comparison of
oxymatrine versus vitamins in one study, nearly half of 43 patients had
reduced their viral load to non-detectable levels, compared to only one
patient taking vitamins, researchers at the University of Shanghai in
China reported.17
However, while liver enzyme levels were higher in the treatment group after two months of treatment, they were generally the same between both groups after 3 months, the researchers reported.
In the end, Coon and Frist "identified several promising complementary therapies", but definitive conclusions couldn't be drawn because of questionable designs of the studies they had researched.
"More research is warranted to establish the role of these and other therapies in the treatment of hepatitis C," they wrote.
1. Coon JT, Frist E. Complementary and
alternative therapies in the treatment of chronic hepatitis C: A
systematic review. J Hepatol 2004 Mar;40(3):491-500.
2. Strader DB, Bacon BR, Lindsay KL et al. Use of complementary and
alternative medicine in patients with liver disease. Am J
Gastroenterol 2002;97(9):2391-7.
3. Mahmood S, Yamada G, Niiyama G, Kawanaka M et al. Effect of vitamin E
on serum aminotransferase and thioredoxin levels in patients with viral
hepatitis C. Free Radic Res 2003 Jul37(7):781-5.
4. NIH Clinical Center. National Institutes of Health.
5. Dr. Andrew Weil. Ask Dr. Weil.
6. Raymond RS, Fallon MB, Abrams GA. Oral thymic extract for chronic
hepatitis C in patients previously treated with interferon. A randomized,
double-blind, placebo-controlled trial. Ann Intern Med 1998 Nov
15;129(10):797-800.
7. Andreone P, Gramenzi A, Cursaro C et al. Thymosin-alpha 1 plus
interferon-alpha for naïve patients with chronic hepatitis C: Results of a
randomized controlled pilot trial. J Viral Hepat 2004
Jan;11(1):69-73.
8. Moscarella S, Buzzelli G, Romanelli RG et al. Interferon and thymosin
combination therapy in naïve patients with chronic hepatitis C:
Preliminary results. Liver 1998 Oct;18(5):366-9.
9. Takagi H, Nagamine T, Abe T et al. Zinc supplementation enhances the
response to interferon therapy in patients with chronic hepatitis C. J
Viral Hepat 2001 Sep;8(5):367-71.
10. Nagamine T, Takagi H, Takayama H et al. Preliminary study of
combination therapy with interferon-alpha and zinc in chronic hepatitis C
patients with genotype 1b. Biol Trace Elem Res 2000
Summer;75(1-3):53-63.
11. Sinclair S. Chinese herbs: A clinical review of Astragalus, Ligusticum
and Schizandrae. Altern Med Rev 1998;3(5):338-44.
12. Liu GT. Pharmacological actions and clinical use of fructus
schizandrae. Chinese Medical Journal 1989;102(10):740-9.
13. National Center for Complementary and Alternative Medicine. (NCCAM).
14. Shibata S. A drug over the millennia: Pharmacognosy, chemistry and
pharmacology of licorice. Yakugaku Zasshi 2000;120(10):849-62.
15. van Rossum TG, Vulto AG, de Man RA et al. Review article: Glycyrrhizin
as a potential treatment for chronic hepatitis C. Alimentary
pharmacology & Therapeutics 1998;12(3):199-205.
16. Arase Y, Ikeda K, Murashima N et al. The long term efficacy of
glycyrrhizin in chronic hepatitis C patients. Cancer
1997;79(8):1494-1500.
17. Li J, Li C, Zeng M. Preliminary study on therapeutic effect of
oxymatrine in treating patients with chronic hepatitis C. Zhongguo
Zhong Xi Yi Jie He Za Zhi 1998 Apr;18
John Martin is a long-time health journalist and an editor for
Priority Healthcare. His credits include coverage of health news for the
website of Fox Television's The Health Network, and articles for the New
York Post and other consumer and trade publications.
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