Efficacy and Safety of Sipjeondaebo-Tang for Anorexia in Patients with Cancer: A Pilot, Randomized, Double-Blind, Placebo-Controlled Trial

Chunhoo Cheon, Jeong-Eun Yoo, Hwa-Seung Yoo, Chong-Kwan Cho, Sohyeon Kang, Mia Kim, Bo-Hyoung Jang, Yong-Cheol Shin, Seong-Gyu Ko, Chunhoo Cheon, Jeong-Eun Yoo, Hwa-Seung Yoo, Chong-Kwan Cho, Sohyeon Kang, Mia Kim, Bo-Hyoung Jang, Yong-Cheol Shin, Seong-Gyu Ko

Abstract

Background: Anorexia occurs in about half of cancer patients and is associated with high mortality rate. However, safe and long-term use of anorexia treatment is still an unmet need.

Objective: The purpose of the present study was to examine the feasibility of Sipjeondaebo-tang (Juzen-taiho-to, Shi-Quan-Da-Bu-Tang) for cancer-related anorexia.

Methods: A total of 32 participants with cancer anorexia were randomized to either Sipjeondaebo-tang group or placebo group. Participants were given 3 g of Sipjeondaebo-tang or placebo 3 times a day for 4 weeks. The primary outcome was a change in the Anorexia/Cachexia Subscale of Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The secondary outcomes included Visual Analogue Scale (VAS) of anorexia, FAACT scale, and laboratory tests.

Results: Anorexia and quality of life measured by FAACT and VAS were improved after 4 weeks of Sipjeondaebo-tang treatment. However, there was no significant difference between changes of Sipjeondaebo-tang group and placebo group.

Conclusions: In the present study, [corrected] Sipjeondaebo-tang did not show a significant effect on anorexia [corrected]in patients with cancer. Further large-scale studies which compensate for the limitations of this study are needed to assess [corrected] the efficacy.

Trial registration: This trial is registered with ClinicalTrials.gov NCT02468141.

Figures

Figure 1
Figure 1
Participants flow chart.
Box 1
Box 1
Participants eligibility criteria.

References

    1. Brown J. K. A systematic review of the evidence on symptom management of cancer-related anorexia and cachexia. Oncology Nursing Forum. 2002;29(3):517–532. doi: 10.1188/02.ONF.517-532.
    1. Fearon K. C. H., Moses A. G. W. Cancer cachexia. International Journal of Cardiology. 2002;85(1):73–81. doi: 10.1016/s0167-5273(02)00235-8.
    1. Muscaritoli M., Bossola M., Aversa Z., Bellantone R., Rossi Fanelli F. Prevention and treatment of cancer cachexia: new insights into an old problem. European Journal of Cancer. 2006;42(1):31–41. doi: 10.1016/j.ejca.2005.07.026.
    1. Ezzo J. M., Richardson M. A., Vickers A., et al. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database of Systematic Reviews. 2006;19(2)CD002285
    1. Kang M. K., Suh E. E. The effects of P6 acupressure and guided imagery on nausea, vomiting, retching and anorexia of the patients with thyroid cancer undergoing radioactive iodine therapy. Asian Oncology Nursing. 2013;13(4):p. 184. doi: 10.5388/aon.2013.13.4.184.
    1. Jeon J.-H., Yoon J., Cho C.-K., et al. Effect of acupuncture for radioactive-iodine-induced anorexia in thyroid cancer patients: a randomized, double-blinded, sham-controlled pilot study. Integrative Cancer Therapies. 2015;14(3):221–230. doi: 10.1177/1534735415570634.
    1. Ruiz-Garcia V., Juan O., Perez Hoyos S. Megestrol acetate: a systematic review usefulness about the weight gain in neoplastic patients with cachexia. Medicina Clinica. 2002;119(5):166–170. doi: 10.1016/S0025-7753(02)73352-6.
    1. Bruera E., Belzile M., Neumann C., Harsanyi Z., Babul N., Darke A. A double-blind, crossover study of controlled-release metoclopramide and placebo for the chronic nausea and dyspepsia of advanced cancer. Journal of Pain and Symptom Management. 2000;19(6):427–435. doi: 10.1016/S0885-3924(00)00138-X.
    1. Neary N. M., Small C. J., Wren A. M., et al. Ghrelin increases energy intake in cancer patients with impaired appetite: acute, randomized, placebo-controlled trial. The Journal of Clinical Endocrinology & Metabolism. 2004;89(6):2832–2836. doi: 10.1210/jc.2003-031768.
    1. Korea Food and Drug Administration. Research on Intake of Chinese Medicine by Korean. Seoul, Korea: Korea Food and Drug Administration; 2006.
    1. Ministry of Food and Drug Safety, Online medicine library ( ), 2017, .
    1. Utsuyama M., Seidlar H., Kitagawa M., Hirokawa K. Immunological restoration and anti-tumor effect by Japanese herbal medicine in aged mice. Mechanisms of Ageing and Development. 2001;122(3):341–352. doi: 10.1016/s0047-6374(00)00249-9.
    1. Choi Y. K., Jung K. Y., Woo S.-M., et al. Effect of sipjeondaebo-tang on cancer-induced anorexia and cachexia in ct-26 tumor-bearing mice. Mediators of Inflammation. 2014;2014:10. doi: 10.1155/2014/736563.736563
    1. Cheon C., Park S., Park Y. L., et al. Sipjeondaebo-tang in patients with cancer with anorexia: A protocol for a pilot, randomised, controlled trial. BMJ Open. 2016;6(5) doi: 10.1136/bmjopen-2016-011212.e011212
    1. Ministry of Food and Drug Safety. The Korean Herbal Pharmacopoeia. Seoul, Korea: Ministry of Food and Drug Safety; 2017.
    1. Ministry of Food and Drug Safety. The Korean Pharmacopoeia. eoul, Korea: Ministry of Food and Drug Safety; 2017.
    1. FACIT, , 2017, .
    1. Terasawa K. Kampo: Japanese-oriental medicine: insights from clinical cases. K.K. Standard McIntyre, 1993.
    1. Fujitsuka N., Uezono Y. Rikkunshito, a ghrelin potentiator, ameliorates anorexia-cachexia syndrome. Frontiers in Pharmacology. 2014;5, article 271 doi: 10.3389/fphar.2014.00271.
    1. Zanchi D., Depoorter A., Egloff L., et al. The impact of gut hormones on the neural circuit of appetite and satiety: A systematic review. Neuroscience & Biobehavioral Reviews. 2017;80:457–475. doi: 10.1016/j.neubiorev.2017.06.013.
    1. De Silva A., Bloom S. R. Gut hormones and appetite control: A focus on PYY and GLP-1 as therapeutic targets in obesity. Gut and Liver. 2012;6(1):10–20. doi: 10.5009/gnl.2012.6.1.10.
    1. Kogure T., Ltoh K., Tatsumi T., et al. The effect of Juzen-taiho-to/TJ-48 on the expression of killer-cell immunoglobulin-like receptors (CD158a/b) on peripheral lymphocytes in vitro experiment. Phytomedicine. 2005;12(5):327–332. doi: 10.1016/j.phymed.2004.05.002.
    1. Kamiyama H., Takano S., Ishikawa E., Tsuboi K., Matsumura A. Anti-angiogenic and immunomodulatory effect of the herbal medicine “Juzen-taiho-to” on malignant glioma. Biological & Pharmaceutical Bulletin. 2005;28(11):2111–2116. doi: 10.1248/bpb.28.2111.
    1. Ishikawa S., Ishikawa T., Tezuka C., Asano K., Sunagawa M., Hisamitsu T. Efficacy of juzentaihoto for tumor immunotherapy in B16 melanoma metastasis model. Evidence-Based Complementary and Alternative Medicine. 2017;2017:8. doi: 10.1155/2017/6054706.6054706
    1. Ishikawa S., Ishikawa T., Asano K., et al. Suppressive effect of juzentaihoto on vascularization induced by b16 melanoma cells in vitro and in vivo. Evidence-Based Complementary and Alternative Medicine. 2012;2012:9. doi: 10.1155/2012/945714.945714
    1. Ogawa K., Omatsu T., Matsumoto C., et al. Protective effect of the Japanese traditional medicine juzentaihoto on myelosuppression induced by the anticancer drug TS-1 and identification of a potential biomarker of this effect. BMC Complementary and Alternative Medicine. 2012;12, article no. 118 doi: 10.1186/1472-6882-12-118.
    1. Nakamoto H., Mimura T., Honda N. Orally administrated Juzen-taiho-to/TJ-48 ameliorates erythropoietin (rHuEPO)-resistant anemia in patients on hemodialysis. Hemodialysis International. 2008;12(2):S9–S14. doi: 10.1111/j.1542-4758.2008.00317.x.
    1. Ishiura Y., Shiba Y., Terasaki Y., et al. Effect of Japanese traditional medicine, TJ-48, on the quality of life of patients with non-small cell lung cancer receiving outpatient chemotherapy. Cancer & Chemotherapy. 2016;43(3):331–334.
    1. Ikemoto T., Shimada M., Iwahashi S., et al. Changes of immunological parameters with administration of Japanese Kampo medicine (Juzen-Taihoto/TJ-48) in patients with advanced pancreatic cancer. International Journal of Clinical Oncology. 2014;19(1):81–86. doi: 10.1007/s10147-013-0529-6.
    1. World Health Organization Western Pacific Regional Office. WHO international standard terminologies on traditional medicine in the western pacific region. World Health Organization, Manila, 2007.
    1. Lee J. J., Lee J. J. A phase II study of an herbal decoction that includes astragali radix for cancer-associated anorexia in patients with advanced cancer. Integrative Cancer Therapies. 2010;9(1):24–31. doi: 10.1177/1534735409359180.
    1. Fujimoto K., Sakata T., Ishimaru T., et al. Attenuation of anorexia induced by heat or surgery during sustained administration of ginsenoside Rg1 into rat third ventricle. Psychopharmacology. 1989;99(2):257–260. doi: 10.1007/BF00442819.
    1. Cheng K.-C., Li Y.-X., Cheng J.-T. The use of herbal medicine in cancer-related anorexia/cachexia treatment around the world. Current Pharmaceutical Design. 2012;18(31):4819–4826. doi: 10.2174/138161212803216979.
    1. Woo S.-M., Choi Y. K., Kim A.-J., et al. Sip-jeon-dea-bo-tang, a traditional herbal medicine, ameliorates cisplatin-induced anorexia via the activation of JAK1/STAT3-mediated leptin and IL-6 production in the fat tissue of mice. Molecular Medicine Reports. 2016;13(4):2967–2972. doi: 10.3892/mmr.2016.4889.

Source: PubMed

3
Subscribe