Topical Herbal Formulae in the Management of Psoriasis: Systematic Review with Meta-Analysis of Clinical Studies and Investigation of the Pharmacological Actions of the Main Herbs.

School of Health Sciences, and Traditional and Complementary Medicine Research Program, Health Innovations Research Institute, RMIT University, Bundoora, VIC, 3083, Australia.
Phytotherapy Research (Impact Factor: 2.4). 07/2013; DOI: 10.1002/ptr.5028
Source: PubMed

ABSTRACT This systematic review and meta-analysis of randomized controlled trials (RCTs) examined the topical use of multi-herbal formulations for the management of psoriasis vulgaris. Studies were identified from PubMed, Cochrane library, EMBASE, and the Chinese databases CNKI and CQVIP. Methods were according to the Cochrane Handbook and meta-analyses used RevMan 5.1. Nine studies met the inclusion/exclusion criteria. The comparisons were with placebo and/or anti-psoriatic pharmacotherapy (APP) with two studies having three arms. The pooled meta-analysis data indicated the topical herbal formulae improved overall clinical efficacy (defined as 50% improvement or greater) when compared with: topical placebo (plus oral herbal co-intervention); topical APP alone; and topical APP (plus pharmaceutical co-intervention). Improvement was evident in Modified Psoriasis Area and Severity Index (PASI) score when topical herbal formula was compared to placebo (plus oral herbal co-intervention). No serious adverse events were reported. The most commonly used herbs were Sophora flavescens root and Lithospermum erythrorhizon root. Experimental studies reported that these herbs and/or their constituents have anti-inflammatory, anti-proliferative, anti-angiogenic, and tissue repair actions. These actions may at least partially explain the apparent benefits of the topical multi-herbal formulations in psoriasis. Copyright © 2013 John Wiley & Sons, Ltd.

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    Trials 07/2014; 15(1):294. · 2.12 Impact Factor
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    ABSTRACT: This review provides assessments of the efficacy and safety of oral forms of phytotherapy in psoriasis management and discusses the pharmacological actions of the plants that have been frequently used in clinical trials. It employed the methods described in the Cochrane Handbook. Ten randomized controlled trials that compared a plant-based intervention with placebo or a pharmacotherapy in the treatment of psoriasis vulgaris and used Psoriasis Area Severity Index (PASI) as an outcome measure were included. Superiority to placebo was found in two out of three studies. In six out of seven studies, the effect of the phytotherapy was reported as comparable to the pharmacotherapy in the short term when assessed as PASI 50. The safety of the phytotherapies was discussed. The most commonly used plants were Oldenlandia diffusa, Rehmannia glutinosa and Salvia miltiorrhiza. Experimental studies on extracts and compounds derived from these plants have reported anti-inflammatory, anti-proliferative and other actions of relevance to psoriasis management. These properties may account for the apparent actions of some of the phytotherapies used in these clinical studies. These plants and their active constituents appear to warrant further research attention in the search for future medications for psoriasis.
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May 30, 2014