Butterbur Herbal Extract May Be Effective for Allergic Rhinitis

Laurie Barclay, MD

December 21, 2004

Dec. 21, 2004 -- An herbal extract called Butterbur Ze339 is effective for the treatment of allergic rhinitis, according to the results of a randomized, double-blind study published in the December issue of the Archives of Otolaryngology-Head & Neck Surgery.

"Butterbur Ze339 is a special extract obtained from the leaves of the butterbur plant ( Petasites hybridus, butter dock, bog rhubarb, and exwort)," write Andreas Schapowal, MD, PhD, from the Allergy Clinic in Landquart, Switzerland, and colleagues from the Petasites Study Group. "The use of herbal treatments in the last decade has increased tremendously, often by physicians' recommendation and frequently after requests from patients; consequently, the number of published randomized controlled trials with herbal medicines has increased substantially."

In this prospective, parallel-group comparison, 186 patients from six outpatient general medicine and allergy clinics were randomized to high-dose Butterbur Ze339 (one tablet three times daily), low-dose Butterbur Ze339 (one tablet twice daily), or placebo for two consecutive weeks. All patients had skin allergy tests confirming intermittent allergic rhinitis by established diagnostic criteria.

The primary outcome was change in daytime symptoms from baseline to end point, and secondary outcomes were Clinical Global Impression score, change in symptoms from baseline to treatment day 7, and response rates. Analysis was by intent-to-treat.

Compared with placebo, improvement in the primary outcome was significantly superior in the Butterbur Ze339 groups, and there was a significant dose relationship. The Butterbur groups also fared significantly better in terms of clinicians' assessment of efficacy and overall responder rates. Adverse events were similar in type and frequency in all three groups.

"Butterbur Ze339 is an effective treatment for intermittent allergic rhinitis symptoms and is well tolerated," the authors write. "The effects of this herbal medicine are clear to patients and physicians in a double-blind evaluation against placebo."

Arch Otolaryngol Head Neck Surg. 2004;139:1381-1386

Reviewed by Gary D. Vogin, MD

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