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Artichoke leaf extract for treating hypercholesterolaemia.

Abstract

BACKGROUND

Hypercholesterolaemia is directly associated with an increased risk for coronary heart disease and other sequelae of atherosclerosis. Artichoke leaf extract (ALE) has been implicated in lowering cholesterol levels. Whether ALE is truly effective for this indication, however, is still a matter of debate.

OBJECTIVES

To assess the evidence of ALE versus placebo or reference medication for treating hypercholesterolaemia defined as mean total cholesterol levels of at least 5.17 mmol/L (200 mg/dL).

SEARCH STRATEGY

We searched the Cochrane Central Register of Controlled Trials 2008 Issue 2, MEDLINE, EMBASE, AMED and CINAHL from their respective inception until June 2008; CISCOM until June 2001. Reference lists of articles were checked. Manufacturers of preparations containing artichoke extract and experts on the subject were contacted.

SELECTION CRITERIA

Randomised controlled trials (RCTs) of ALE mono-preparations compared with placebo or reference medication for patients with hypercholesterolaemia were included. Trials assessing ALE as one of several active components in a combination preparation or as a part of a combination treatment were excluded.

DATA COLLECTION AND ANALYSIS

Data were extracted systematically and methodological quality was evaluated using a standard scoring system and the Cochrane risk of bias assessment. The screening of studies, selection, data extraction and assessment of methodological quality were performed independently by two reviewers. Disagreements in the evaluation of individual trials were resolved through discussion.

MAIN RESULTS

Three RCTs (262 participants) met all inclusion criteria. In one trial the total cholesterol level in participants receiving ALE decreased by 4.2% from 7.16 (0.62) mmol/L to 6.86 (0.68) mmol/L after 12 weeks and increased from 6.90 (0.49) mmol/L to 7.04 (0.61) mmol/L in patients receiving placebo, the total difference being statistically significant (P = 0.025). In a further trial ALE reduced total cholesterol levels by 18.5% from 7.74 mmol/L to 6.31 mmol/L after 42 +/- 3 days of treatment whereas the placebo reduced cholesterol by 8.6% from 7.69 mmol/L to 7.03 mmol/L (P = 0.00001). Another trial did state that ALE significantly reduced blood cholesterol compared with placebo in a sub-group of patients with baseline total cholesterol levels of more than 230 mg/dL (P < 0.05). Trial reports indicate mild, transient and infrequent adverse events.

AUTHORS' CONCLUSIONS

Some data from clinical trials assessing ALE for treating hypercholesterolaemia exist. There is an indication that ALE has potential in lowering cholesterol levels, the evidence is, however, as yet not convincing. The limited data on safety suggest only mild, transient and infrequent adverse events with the short term use of ALE.

Authors+Show Affiliations

Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, 25 Victoria Park Road, Exeter, UK, EX2 4NT.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

19821306

Citation

Wider, Barbara, et al. "Artichoke Leaf Extract for Treating Hypercholesterolaemia." The Cochrane Database of Systematic Reviews, 2009, p. CD003335.
Wider B, Pittler MH, Thompson-Coon J, et al. Artichoke leaf extract for treating hypercholesterolaemia. Cochrane Database Syst Rev. 2009.
Wider, B., Pittler, M. H., Thompson-Coon, J., & Ernst, E. (2009). Artichoke leaf extract for treating hypercholesterolaemia. The Cochrane Database of Systematic Reviews, (4), CD003335. https://doi.org/10.1002/14651858.CD003335.pub2
Wider B, et al. Artichoke Leaf Extract for Treating Hypercholesterolaemia. Cochrane Database Syst Rev. 2009 Oct 7;(4)CD003335. PubMed PMID: 19821306.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Artichoke leaf extract for treating hypercholesterolaemia. AU - Wider,Barbara, AU - Pittler,Max H, AU - Thompson-Coon,Joanna, AU - Ernst,Edzard, Y1 - 2009/10/07/ PY - 2009/10/13/entrez PY - 2009/10/13/pubmed PY - 2010/1/28/medline SP - CD003335 EP - CD003335 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 4 N2 - BACKGROUND: Hypercholesterolaemia is directly associated with an increased risk for coronary heart disease and other sequelae of atherosclerosis. Artichoke leaf extract (ALE) has been implicated in lowering cholesterol levels. Whether ALE is truly effective for this indication, however, is still a matter of debate. OBJECTIVES: To assess the evidence of ALE versus placebo or reference medication for treating hypercholesterolaemia defined as mean total cholesterol levels of at least 5.17 mmol/L (200 mg/dL). SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials 2008 Issue 2, MEDLINE, EMBASE, AMED and CINAHL from their respective inception until June 2008; CISCOM until June 2001. Reference lists of articles were checked. Manufacturers of preparations containing artichoke extract and experts on the subject were contacted. SELECTION CRITERIA: Randomised controlled trials (RCTs) of ALE mono-preparations compared with placebo or reference medication for patients with hypercholesterolaemia were included. Trials assessing ALE as one of several active components in a combination preparation or as a part of a combination treatment were excluded. DATA COLLECTION AND ANALYSIS: Data were extracted systematically and methodological quality was evaluated using a standard scoring system and the Cochrane risk of bias assessment. The screening of studies, selection, data extraction and assessment of methodological quality were performed independently by two reviewers. Disagreements in the evaluation of individual trials were resolved through discussion. MAIN RESULTS: Three RCTs (262 participants) met all inclusion criteria. In one trial the total cholesterol level in participants receiving ALE decreased by 4.2% from 7.16 (0.62) mmol/L to 6.86 (0.68) mmol/L after 12 weeks and increased from 6.90 (0.49) mmol/L to 7.04 (0.61) mmol/L in patients receiving placebo, the total difference being statistically significant (P = 0.025). In a further trial ALE reduced total cholesterol levels by 18.5% from 7.74 mmol/L to 6.31 mmol/L after 42 +/- 3 days of treatment whereas the placebo reduced cholesterol by 8.6% from 7.69 mmol/L to 7.03 mmol/L (P = 0.00001). Another trial did state that ALE significantly reduced blood cholesterol compared with placebo in a sub-group of patients with baseline total cholesterol levels of more than 230 mg/dL (P < 0.05). Trial reports indicate mild, transient and infrequent adverse events. AUTHORS' CONCLUSIONS: Some data from clinical trials assessing ALE for treating hypercholesterolaemia exist. There is an indication that ALE has potential in lowering cholesterol levels, the evidence is, however, as yet not convincing. The limited data on safety suggest only mild, transient and infrequent adverse events with the short term use of ALE. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/19821306/Artichoke_leaf_extract_for_treating_hypercholesterolaemia_ L2 - https://doi.org/10.1002/14651858.CD003335.pub2 DB - PRIME DP - Unbound Medicine ER -