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Efficacy and short-term safety of topical Dwarf Elder (Sambucus ebulus L.) versus diclofenac for knee osteoarthritis: A randomized, double-blind, active-controlled trial.
J Ethnopharmacol. 2016 Jul 21; 188:80-6.JE

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE

Sambucus ebulus L. (S. ebulus) has had long-standing application in Traditional Persian Medicine for joint pain and for a variety of bone and joint disorders. According to traditional use of S. ebulus and its relevant pharmacologic properties, this study was designed to evaluate the efficacy and short-term safety of topical use of S. ebulus in patients with knee osteoarthritis (OA).

METHODS AND MATERIALS

Seventy nine patients with knee OA were randomly enrolled in 2 parallel arms of a pilot randomized, double-blind, active-controlled clinical trial. The patients were treated by topical S. ebulus gel or 1% diclofenac gel, three times a day, as much as a fingertip unit for 4 weeks. Patients were assessed prior to enrollment and, then, 2 and 4 weeks subsequent to the intervention, in terms of scores of visual analogue scale (VAS) for self-grading of their knee joint pain, and according to 3 different domains of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Any observed adverse effects were also scrutinized.

RESULTS

The mean values of WOMAC pain score, total WOMAC score and VAS score for pain of the S. ebulus group were significantly lower compared with the diclofenac group (P=0.004, P=0.04, and P<0.001, respectively). In addition, no serious adverse effect was reported.

CONCLUSION

This pilot study showed that topical treatment with S. ebulus gel can be recommended for alleviating symptoms of patients with knee OA. However, longer trials involving larger samples size, are needed for achieving a comprehensive understanding about the efficacy and safety of S. ebulus in knee OA.

Authors+Show Affiliations

Department of Traditional Medicine, Faculty of Iranian Traditional Medicine, Shahid Sadoughi University of Medical Sciences, Ardakan, Yazd, Iran.Department of Traditional Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran; Essence of Parsiyan Wisdom Institute, Phytopharmaceutical and Traditional Medicine Incubator, Shiraz University of Medical Sciences, Shiraz, Iran.Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Physical Medicine and Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.Department of Pharmaceutics, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: mkamalinejad@yahoo.com.Department of Traditional Medicine, Faculty of Iranian Traditional Medicine, Shahid Sadoughi University of Medical Sciences, Ardakan, Yazd, Iran; The Research Center of The Iranian Traditional Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Electronic address: dr.emtiazy@ssu.ac.ir.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27125590

Citation

Jabbari, Marzie, et al. "Efficacy and Short-term Safety of Topical Dwarf Elder (Sambucus Ebulus L.) Versus Diclofenac for Knee Osteoarthritis: a Randomized, Double-blind, Active-controlled Trial." Journal of Ethnopharmacology, vol. 188, 2016, pp. 80-6.
Jabbari M, Hashempur MH, Razavi SZ, et al. Efficacy and short-term safety of topical Dwarf Elder (Sambucus ebulus L.) versus diclofenac for knee osteoarthritis: A randomized, double-blind, active-controlled trial. J Ethnopharmacol. 2016;188:80-6.
Jabbari, M., Hashempur, M. H., Razavi, S. Z., Shahraki, H. R., Kamalinejad, M., & Emtiazy, M. (2016). Efficacy and short-term safety of topical Dwarf Elder (Sambucus ebulus L.) versus diclofenac for knee osteoarthritis: A randomized, double-blind, active-controlled trial. Journal of Ethnopharmacology, 188, 80-6. https://doi.org/10.1016/j.jep.2016.04.035
Jabbari M, et al. Efficacy and Short-term Safety of Topical Dwarf Elder (Sambucus Ebulus L.) Versus Diclofenac for Knee Osteoarthritis: a Randomized, Double-blind, Active-controlled Trial. J Ethnopharmacol. 2016 Jul 21;188:80-6. PubMed PMID: 27125590.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and short-term safety of topical Dwarf Elder (Sambucus ebulus L.) versus diclofenac for knee osteoarthritis: A randomized, double-blind, active-controlled trial. AU - Jabbari,Marzie, AU - Hashempur,Mohammad Hashem, AU - Razavi,Seyede Zahra Emami, AU - Shahraki,Hadi Raeisi, AU - Kamalinejad,Mohammad, AU - Emtiazy,Majid, Y1 - 2016/04/26/ PY - 2015/12/22/received PY - 2016/03/20/revised PY - 2016/04/22/accepted PY - 2016/4/30/entrez PY - 2016/4/30/pubmed PY - 2017/4/22/medline KW - Diclofenac KW - Dwarf elder KW - Herbal Medicine KW - Osteoarthritis KW - Sambucus ebulus L. KW - Traditional Persian Medicine SP - 80 EP - 6 JF - Journal of ethnopharmacology JO - J Ethnopharmacol VL - 188 N2 - ETHNOPHARMACOLOGICAL RELEVANCE: Sambucus ebulus L. (S. ebulus) has had long-standing application in Traditional Persian Medicine for joint pain and for a variety of bone and joint disorders. According to traditional use of S. ebulus and its relevant pharmacologic properties, this study was designed to evaluate the efficacy and short-term safety of topical use of S. ebulus in patients with knee osteoarthritis (OA). METHODS AND MATERIALS: Seventy nine patients with knee OA were randomly enrolled in 2 parallel arms of a pilot randomized, double-blind, active-controlled clinical trial. The patients were treated by topical S. ebulus gel or 1% diclofenac gel, three times a day, as much as a fingertip unit for 4 weeks. Patients were assessed prior to enrollment and, then, 2 and 4 weeks subsequent to the intervention, in terms of scores of visual analogue scale (VAS) for self-grading of their knee joint pain, and according to 3 different domains of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Any observed adverse effects were also scrutinized. RESULTS: The mean values of WOMAC pain score, total WOMAC score and VAS score for pain of the S. ebulus group were significantly lower compared with the diclofenac group (P=0.004, P=0.04, and P<0.001, respectively). In addition, no serious adverse effect was reported. CONCLUSION: This pilot study showed that topical treatment with S. ebulus gel can be recommended for alleviating symptoms of patients with knee OA. However, longer trials involving larger samples size, are needed for achieving a comprehensive understanding about the efficacy and safety of S. ebulus in knee OA. SN - 1872-7573 UR - https://www.unboundmedicine.com/medline/citation/27125590/Efficacy_and_short_term_safety_of_topical_Dwarf_Elder__Sambucus_ebulus_L___versus_diclofenac_for_knee_osteoarthritis:_A_randomized_double_blind_active_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0378-8741(16)30236-7 DB - PRIME DP - Unbound Medicine ER -