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Placebo controlled evaluation of Xilei San, a herbal preparation in patients with intractable ulcerative proctitis
Author(s) -
Fukunaga Ken,
Ohda Yoshio,
Hida Nobuyuki,
Iimuro Masaki,
Yokoyama Yoko,
Kamikozuru Koji,
Nagase Kazuko,
Nakamura Shiro,
Miwa Hiroto,
Matsumoto Takayuki
Publication year - 2012
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2012.07215.x
Subject(s) - medicine , placebo , suppository , ulcerative colitis , proctitis , clinical endpoint , gastroenterology , corticosteroid , inflammatory bowel disease , clinical trial , surgery , disease , pharmacology , pathology , alternative medicine
Background and Aim: Topical mesalamine or corticosteroid has shown efficacy in patients with ulcerative proctitis, but patients often become refractory to these interventions. Xilei San is a herbal preparation with evidence of anti‐inflammatory effects. We evaluated the efficacy of topical Xilei San in ulcerative proctitis patients. Methods: In a double blind setting, 30 patients with intractable ulcerative proctitis despite ≥ 4 weeks of topical mesalamine or corticosteroid were randomly assigned to True ( n = 15) and placebo ( n = 15). Patients in True received suppository Xilei San (0.1 g/dose per day of Xilei San), the other 15 received placebo suppository. The initial efficacy was evaluated on day 14. Primary endpoint of the trial was avoiding relapse during 180 days, relapse meant recurrence of active disease. Riley's index was applied for endoscopic and histological evaluations, while patients' quality of life was evaluated by an inflammatory bowel disease questionnaire. Results: On day 14, the number of patients who achieved remission, clinical activity index ≤ 4 in True was significantly higher versus placebo ( P < 0.04). Likewise, at day 180, an 81.8% of patients in True were without relapse versus 16.7% in placebo ( P < 0.001). Further, significant endoscopic ( P < 0.01), histological ( P < 0.02) and inflammatory bowel disease questionnaire ( P < 0.04) improvements were observed in True, but not in placebo. Conclusions: This is the first controlled investigation showing significant clinical and endoscopic efficacy for Xilei San in patients with intractable ulcerative proctitis. Topical Xilei San was well tolerated, and was without safety concerns.