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International Journal of Pharmacology
Year: 2013  |  Volume: 9  |  Issue: 4  |  Page No.: 227 - 244

Comparison of the Efficacy and Tolerability of Herbal Medicines with 5-aminosalisylates in Inflammatory Bowel Disease: A Meta-analysis of Placebo Controlled Clinical Trials Involving 812 Patients

Roja Rahimi, Shekoufeh Nikfar and Mohammad Abdollahi    

Abstract: The use of herbal medicine for the management of Inflammatory Bowel Disease (IBD) is increasing. The aim of the present study is to compare the efficacy and tolerability of herbal medicines with 5-aminosalicylates (5-ASAs) in IBD by conducting a meta-analysis. For this purpose, electronic databases were searched for studies comparing efficacy and/or tolerability of herbal medicines with 5-ASAs in different types of IBD. The search terms were: “herb” or “plant” or “herbal” and “inflammatory bowel disease”. Data were collected from 1966-2013 (up to Feb). The “clinical response”, “clinical remission”, “endoscopic response”, “endoscopic remission”, “histological response”, “histological remission”, “relapse”, “any adverse events” and “serious adverse events” were the key outcomes of interest. Eight placebo controlled clinical trials met criteria and were included. Comparison of herbal medicine with 5-ASAs yielded the following results: a significant Relative Risk (RR) of 1.28 (95% Confidence Interval (CI): 1.07-1.54, p = 0.008) for clinical remission; a significant RR of 1.19 (95% CI = 1.01-1.39, p = 0.04) for clinical response; a non-significant RR of 0.85 (95% CI: 0.34-2.12, p = 0.73) for endoscopic remission; a non-significant RR of 1.14 (95% CI: 0.99-1.3, p = 0.07) for endoscopic response; a non-significant RR of 0.8 (95% CI: 0.05-13.72) for histological remission; a non-significant RR of 1.32 (95% CI: 0.64-2.9) for histological response; a non-significant RR of 1.05 (95% CI: 0.6-1.83, p = 0.87) for relapse; a non-significant RR of 1.31 (95% CI: 0.8-2.14, p = 0.28) for any adverse events; and a non-significant RR of 1.8 (95% CI: 0.13-24.5, p = 0.66) for serious adverse events. Overall, the efficacy and tolerability of herbal medicines in IBD is comparable to 5-ASAs, but the evidence is too limited to make any confident conclusion. Further high quality, large controlled trials are still needed.

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