• Title/Summary/Keyword: Clinical safety

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Therapeutic Evaluation of a Topical Unani Formulation, Tila-i Muhāsā in Buthūr Labaniyya (Acne Vulgaris): A Randomized, Controlled Clinical Study

  • Azahar, Mohd;Uddin, Qamar;Kazmi, Munawwar Husain;Khatoon, Faiza;Husain, Nazim
    • CELLMED
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    • v.10 no.2
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    • pp.15.1-15.9
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    • 2020
  • Introduction: Buthūr Labaniyya (Acne vulgaris) is a multifactorial disorder of the pilosebaceous units characterized by non-inflammatory and inflammatory clinical lesions. Several Unani medications have been used for centuries to treat acne. Objectives: Evaluation of safety and efficacy of Tila-i Muhāsā in patients with acne vulgaris Materials and Methods: This clinical study was conducted in patients with acne vulgaris. Patients applied Tila-i Muhāsā or 5% Benzoyl Peroxide (BPO) once daily for 6 weeks. Assessment of efficacy was carried out by Global Acne Grading System (GAGS) and Patient Global Assessment (PGA) scores. In addition, overall severity of acne was evaluated on a 5-point Cook's acne grading scale using photographic standards. Assessment of safety was performed through adverse drug reactions, local dermal tolerability, vital signs, and routine laboratory investigations. Results: A total of 60 patients (30 in each group) completed 6 weeks of treatment. The mean percentage reduction in GAGS score at 6 weeks from baseline in Unani group (66.97%) and BPO group (59.09%) was statistically significant (P<0.0001). After 6 weeks of therapy, the mean percentage reduction in PGA score compared to baseline in Unani group (57.44%) and BPO group (50.23%) was statistically significant (P<0.0001). No serious adverse events were reported in both groups; however, mild adverse events occurred more frequently in BPO group (30%) compared to Unani group (10%). Conclusion: Tila-i Muhāsā was found to be effective and safe in the treatment of acne vulgaris. However, further clinical studies with larger sample size and longer duration of therapy need to be conducted.

Review of Clinical Studies for Korean Medicine Treatment on Nocturnal Enuresis in Children (소아 야뇨의 한의학적 치료에 대한 국내외 임상연구 동향 - 2000년 이후 발표된 연구를 중심으로 -)

  • Lee, Yoo Been;Jeong, Aram
    • The Journal of Pediatrics of Korean Medicine
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    • v.34 no.1
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    • pp.1-25
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    • 2020
  • Objectives The purpose of this study is to identify the research trends and to evaluate the effectiveness and safety of Korean medicine treatment by analyzing the recently published clinical studies of Korean medicine treatment on nocturnal enuresis in children. Methods The literatures were searched from OASIS, KISS, NDSL, RISS, Cochrane, CINAHL, Embase, Pubmed, and only clinical studies published from 2000 to October 2019 were included. The publication year, study type, type of enuresis, demographic information of participants, duration of illness, intervention type and details, follow-up period, outcome measurements and adverse events of selected literatures were analyzed. Results A total of 38 studies were selected. In the selected studies, acupuncture was the most frequently used treatment for nocturnal enuresis, followed by herbal medicine, electrical stimulation treatment, moxibustion, acupressure and plaster therapy. The most commonly used acupoints for acupuncture were SP6 and CV4, and the most used herbal medicine was Chukcheonwhan, while Alpiniae Fructus (益智仁) and Dioscoreae Rhizoma (山藥) were the most used herbal materials. Most of the studies showed that the total effective rate of Korean medicine treatment was high. All the adverse events occurred in the Korean medicine treatment group were caused by acupuncture or puncture. Conclusions This study analyzed clinical studies of Korean medicine treatment on nocturnal enuresis in children, identified the research trends and evaluated the effectiveness and safety of the Korean medicine treatment.

Current Status and Expectations of Orphan Drugs in Korea -In point of supplying medicines for the rare diseases- (국내 희귀의약품의 현황 및 과제 -희귀질환에 대한 의약품 공급을 중심으로)

  • Kim, Hee-Eun;Gwak, Hye-Sun
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.107-112
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    • 2006
  • This study was aimed to investigate the current status and expectations of orphan drugs in Korea. The Korea Orphan Drug Center was established to supply many medicines for the patients with rare diseases. Among the medicines supplied by the Center, the number designated as the orphan drugs by the KFDA is quite few. However, a few of medicines are not under circulation even if the items are designated as the orphan drugs. Neoplasm-related medicines, infectious and parasitic disease-related medicines, endocrine, nutritional and metabolic disease-related medicines are the ones circulated most. There are several unapproved drugs among the medicines supplied by the Center. It's because the director of the Center can import the goods without a process to getting an approval from the KFDA. The Korea Orphan Drug Center has contributed to the selection of the medicines for treating the rare disease. On the contrary, some problems remain in the supply process. The safety and effectiveness of the medicines supplied by the Center are not guaranteed. So far, rare diseases have no specific legal definition, and therefore are only referred to in terms of the population of patients, which prevent from establishing the range of medicines. The introduction of Special Access Program or Access to Unapproved Therapeutic Goods will be the solution of these problems. In addition, it is another solution to keep intimate relations with the Rare and Intractable Disease Center and the Medicine Safety Information Center which will be open soon.

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A Clinical Practice Guideline for Ma-huang(Ephedra sinica) Prescription in Obesity (비만치료 및 체중감량에서의 적절한 마황 사용에 대한 임상 진료지침 개발)

  • Kim, Ho-Jun;Han, Chang-Ho;Lee, Eui-Ju;Song, Yun-Kyung;Shin, Byung-Cheul;Kim, Yun-Kyung
    • Journal of Korean Medicine for Obesity Research
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    • v.7 no.2
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    • pp.27-37
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    • 2007
  • Background Clinical practice guidelines (CPG) are systematically developed statements to assist practitioners and patients on healthcare decisions. They provide recommendations for the average patient, which should take into account individual clinical judgment and the patient's values and expectations. Ephedra has sympathomimetic effect and has been used for weight loss worldwide. However, its safety is controversial especially in autonomic and cardiovascular systems. Therefore, the need of appropriate CPG for ephedra prescription in obesity was advocated in Korean Traditional Medicine. Methods The committee comprised of specialists of obesity, oriental herbology, oriental cardiology, constitutional medicine. The committee collected all relevant references about adverse effect and safety of ephedra in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study and observational study from international and domestic databases and paper journals. 11 English- and 5 Korean-language references were gathered and categorized by PICO (Patient, Intervention, Comparison, Outcome) method. We could not complete strength of recommendation which should be clarified according to the evidence grade estimation. Result The first version of CPG for ephedra prescription in obesity was issued by Korean Oriental Association for Study of Obesity. It includes topics of introduction, pharmacokinetics, side effects and adverse events, constitutional aspect and recommendations for dose, indication and contraindication. Conclusion There should be periodic upgrade of this CPG from now on. Although there are some drawbacks in this version of CPG, it has significance as the first CPG in Korean Traditional Medicine.

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Dose range finding study of KOB03, a new polyherbal medicine for the treatment of allergic rhinitis, by oral administration for four weeks in Sprague-Dawley rats (한약제제 KOB03의 랫드에서의 4주 반복 경구투여에 의한 독성 연구)

  • Jung, Jin-Ki;Park, Yong-Ki
    • The Korea Journal of Herbology
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    • v.27 no.3
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    • pp.101-106
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    • 2012
  • Objectives : To evaluate the toxicity of KOB03, polyherbal medicine for the treatment of allergic rhinitis, we performed the dose-range finding test of KOB03 by oral supplementation for 4 weeks in Sprague-Dawley rats. Methods : The water extract of KOB03 consisting of five different herbs was supplied from GLP company. KOB03 was supplemented by gavage at 0, 500, 2,500 and 5,000 mg/kg/day for 4-week consecutive days. We recorded the clinical signs of toxicity, body weight, organ weights, hematology, gross and histological changes in target organs of rats, and clinical chemistry analysis. Results : KOB03 at all doses was shown no mortality or abnormal clinical signs in rats during at the observation period. Furthermore, there was no difference in body weight and food-take consumption, organ weight, gross pathological findings, and urine analysis among the groups of rats treated with different doses of KOB03. The hematological analysis and clinical blood chemistry data were revealed no toxic effects from KOB03-supplemented rats. Conclusions : The results suggest that KOB03 is a wide margin of safety on dose-range toxicity in rats. The no observable adverse effect level (NOAEL) of the test, KOB03 in rats is no less than 5,000 mg/kg/day.

Single Oral Dose Toxicity Test and Four Weeks Repeated Oral Dose Determination Test of GST in Sprague-Dawley Rats (GST의 Sprague-Dawley Rat를 이용한 단회 경구투여 독성시험 및 4주 반복 경구투여 용량결정시험)

  • Han, Jong-Min;Hong, Jee-Hee;Lee, Hye-Yeong;Jung, In-Chul;Jin, Mi-Rim;Kim, Seong-Hyeong;Park, Yang-Chun
    • The Journal of Internal Korean Medicine
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    • v.34 no.4
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    • pp.349-361
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    • 2013
  • Objectives : This study aimed to evaluate the single oral dose toxicity and four weeks repeated dose determination of Gamisasangja-tang (GST) in male and female Sprague-Dawley rats. Methods : In the single oral toxicity study, rats were orally administered a single dose of 0 and 5,000 mg/kg GST. There were 5 rats in each group. After single administration, mortality, clinical signs, body weight changes and gross pathological finding were observed for 14 days. In the 4-weeks repeated oral dose determination study, rats were orally administered a single dose of 0, 1,250, 2,500 or 5,000 mg/kg GST. There were 5 rats in each group. Mortality, clinical signs, body weight changes, food consumption and gross pathological finding were observed for 28 days. Organ weight, clinical chemistry and hematology were tested after 28 days. Results : There was no mortality in either of the two studies. There were also no significant differences in clinical sign, body weight, organ weights, hematological or serum chemical parameters between the GST and control groups. Conclusions : The results obtained in this study suggest that the 50% lethal dose of GST is over 5,000 mg/kg, so this finding would be expected to provide scientific evidence for the safety of GST.

Animal and Clinical Study of the Efficacy of Mulberry Extract Complex on Degenerative Arthritis (상심자추출복합물의 퇴행성관절염 개선 효능에 대한 동물실험 및 임상연구)

  • Kim, Jinku;Ha, Jeongku;Li, Hua;Jeong, Jong-Moon
    • The Korea Journal of Herbology
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    • v.30 no.3
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    • pp.25-34
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    • 2015
  • Objectives : This study was performed to investigate the efficacy and safety of the Mulberry Extract Complex in a placebo-controlled randomized clinical trial and animal study on degenerative arthritis. Methods : Animal study: Mulberry Extract Complex is composed of extracts of mulberry (Morus alba L.) fruit, mulberry leaves and black beans (Glycine max (L.) Merr.). To evaluate the serum level of interleukin-2, interferon-$\gamma$, and prostaglandin E2, an animal model of degenerative arthritis induced by monosodium iodoacetate was employed. Clinical study: The efficacy index (VAS, K-WOMAC) was compared among patients with symptoms of degenerative arthritis before and after Mulberry Extract Complex ingestion as well as the one in groups. Evaluations of the improvement by the subjects and by doctor assessment were also performed. Results : Animal study: Mulberry Extract Complex reduced the serum level of interferon-$\gamma$ and prostaglandin E2 in an animal model with degenerative arthritis. Clinical study: The VAS change showed statistical significance in the experimental groups after 4 weeks (PP set) and 8 weeks (ITT set) of ingestion. When the K-WOMAC was analyzed using a modified ITT set to determine the effectiveness, statistically significant results were obtained in the fields of pain & symptom within the Mulberry Extract Complex group as well as between the Mulberry Extract Complex and placebo groups after 8 weeks of ingestion. Results from the improvement evaluation by subjects and the assessment of improvement by doctors showed statistical significance in the experimental groups (PP set) after 8 weeks. Conclusions : Mulberry Extract Complex could be useful for the improvement of various symptoms of degenerative arthritis based on its anti-inflammatory activity and its reduction of VAS and K-WOMAC pain scores.

Efficacy and Safety of Extract Obtained from Pueraria thunbergiana Bentham and Curcuma longa L. on the Improvement of the Menopausal Symptoms (갈근강황추출물의 갱년기 증상 개선에 대한 유효성 및 안전성 평가)

  • Ahn, Ha-Young;Hur, Da-Hee;Kim, Yong-Jae;Cha, Min-Seok;Lee, Dong-Nyung;Kim, Hyeong-Jun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.4
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    • pp.75-92
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    • 2020
  • Objectives: This clinical trial is performed to investigate the effect of improving the menopausal symptoms and the safety of extract obtained from Pueraria thunbergiana Bentham and Curcuma longa L. in menopausal women Methods: This study was randomized, double blinded, placebo-controlled clinical trial. 110 women with menopausal symptoms were assigned to treatment group (n=55) and control group (n=55). The results of this study were evaluated through changes in Kupperman Index score, Menopause-specific Quality of Life Questionnaire (MENQOL) score, degree of hot flashes and sweating, Body Mass Index(BMI), laboratory test results including female hormones. Results: In the treatment group compared to before baseline, there was significant difference in the Kupperman Index total score, score of each item in the Kupperman Index, MENQOL total score, hot flush and sweating visual analogue scale (VAS), hot flush score, and hot flush duration at one time. However, there was also a significant change compared to baseline in the control group, there was no significant difference between the treatment group and the control group. There was no significant change in female hormone levels in both group, and there were no adverse events associated with the clinical trial product. Conclusions: This clinical trial showed that extract obtained from Pueraria thunbergiana Bentham and Curcuma longa L. was helpful in improving menopausal symptoms in menopausal women without significant side effects.

Strategic Plans for the Implementation of Pharmacometric Methodology in Drug Regulatory Review Decisions (효율적인 의약품 평가를 위한 약물계량학 분석법 도입의 전략 방안)

  • Lee, Sang-Min;Choi, Bo-Yoon;Yun, Hwi-Yeol;Jun, Da-Hae;Kim, Myung-Gou;Ha, Ji-Hye;Kim, Young-Hoon;Ji, Eun-Hee;Kang, Won-Ku;Han, Na-Young;Shin, Wan-Gyoon;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.4
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    • pp.339-346
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    • 2011
  • Over the past few decades, drug regulatory agencies in advanced countries have been emphasizing pharmacometrics as a tool for an effective and efficient drug evaluation. Despite this international movement, the value of pharmacometrics is still poorly recognized by the Korean drug evaluation system. This study aimed to analyze the current state of utilization of pharmacometrics by foreign drug regulatory agencies and develop a road map to guide the implementation pharmacometrics into the Korean drug evaluation system. MEDLINE and foreign drug regulatory agency database were extensively searched to obtain scientific research articles, guidance, regulations and pharmacometric review reports on foreign pharmacometric drug evaluation system. A systematic roadmap comprised of 3 stages to implement pharmacometrics in Korean drug evaluation system was formulated after analyzing the collected data in tune with the current evaluation system. Pharmacometrics is an urgently required tool to achieve an efficient drug evaluation and review in Korea. The road map developed by this study is expected to aid in setting up a policy to implement and utilize pharmacometrics in Korea.

A Review of Recent Clinical Researches in Chinese Medical Journal for Efficacy and Safety of Pediatric Herbal Medicine Inhalation Therapy (소아 무화흡입요법의 효과 및 안전성에 대한 최신 중의학 임상 연구 고찰 - 2010년 이후 발표된 임상 연구 논문을 중심으로 -)

  • Park, Sul Gi;Park, So Hyun;Shin, Dong Gil;Lee, Sun Haeng;Lee, Jin Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.33 no.3
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    • pp.82-102
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    • 2019
  • Objectives The purpose of this study is to investigate clinical studies on the efficacy and safety of herbal medicine inhalation therapy in children by analyzing recent randomized controlled trials conducted in China. Methods We searched the clinical studies from the China Academic Journal (CAJ) in China National Knowledge Infrastructure (CNKI) using a by key word '霧化吸入' and specific criteria from 1st January 2010 to 2nd July 2019. Data regarding years of publication, demographic information, target diseases or symptoms, treatment methods, outcome measure, results and adverse events are collected for this study. Results Total of 44 randomized controlled trials were selected and analyzed. Respiratory diseases and symptoms (84.1%) were the most frequent target diseases that herbal medicine inhalation therapy was used. Acute stomatitis was another disease state that the therapy was used. In most of the studies, the herbal medicine inhalation in children showed significant efficacies. The most commonly used herbal medicines were Ephedrae Herba (麻黃), Lonicera Flos (金銀花), Armeniacae Semen (杏仁), Glycyrrhizae Radix et Rhizoma (甘草), Scutellaria Radix (黃芩), Forsythia Fructus (連翹) etc. Hardly any adverse effects were reported from the trials selected. Conclusions Based on the results of the clinical studies from China, herbal medicine inhalation therapy in children can be an effective and safe option for treatment and symptom improvement.