The efficacy and safety of Hanslim for obese patients: Study protocol for a multicenter, randomized, double-blind, multi-dose, placebo-controlled, phase IIb clinical trial

Seunghoon Lee, Hyeonhoon Lee, Yeeun Cho, Jihye Kim, Jung Won Kang, Byung-Kwan Seo, Yong-Hyeon Baek, Jae-Dong Lee, Seunghoon Lee, Hyeonhoon Lee, Yeeun Cho, Jihye Kim, Jung Won Kang, Byung-Kwan Seo, Yong-Hyeon Baek, Jae-Dong Lee

Abstract

Background: This study aims to evaluate the efficacy, safety, and appropriate dose of Hanslim, a Korean traditional herbal medicine, for obese patients, when compared to a placebo.

Methods/design: This study is a randomized, double-blinded, multicenter, multidose, placebo-controlled, phase IIb clinical trial. A total of 165 obese patients with a body mass index (BMI) of more than 30 kg/m or obese patients with a BMI of 27 to 29.9 kg/m and one or more risk factors such as hypertension, diabetes, or hyperlipidemia will be enrolled. Participants will be randomly assigned to 1 of 3 groups (high-dose, low-dose, or placebo) with a 1:1:1 allocation ratio and will have 4 scheduled visits during the 12-week treatment period. The participants will be administered 2 tablets of Hanslim or placebo, 2 times per day. The difference in the proportion of participants who lost weight by more than 5% from their baseline at 12 weeks compared to the placebo group will be examined as the primary efficacy outcome. Secondary efficacy outcomes include differences in body weight, BMI, body-fat percentage, fat mass, skeletal-muscle mass, edema index, waist circumference, hip circumference, waist-hip ratio, serum lipid, blood glucose, C-reactive protein, and total score of Korean version of obesity-related quality of life after 12 weeks of treatment. Adverse events, laboratory test results, vital sings, and electrocardiography will be recorded to evaluate safety.

Discussion: This is the first prospective clinical trial to explore the efficacy and safety of Hanslim for obese patients. If the results provide the appropriate dosage of Hanslim, this study would contribute to the confirmatory evidence for the use of Hanslim as a treatment for obesity needed to conduct a large-scale, phase III clinical trial. The results will be published in a peer-reviewed journal.

Trial registration: Clinical Research Information Service, ID: KCT0002193. Registered on January 6, 2017. https://cris.nih.go.kr/cris/search/search_result_st01_en.jsp?seq=7468.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Schedule of enrolment, interventions, and assessments. KOQoL = Korean version of obesity-related quality of life, V = visit. ∗Body weight, height, body fat percentage, fat mass, skeletal muscle mass, and edema index will be measured. The height of participants will be measured at visit 1 only. ∗∗blood and urine test. ∗∗∗Documentation checked and finalized.

References

    1. James PT. Obesity: the worldwide epidemic. Clin Dermatol 2004;22:276–80.
    1. Kim CS, Ko S-H, Kwon H-S, et al. Prevalence, awareness, and management of obesity in Korea: data from the Korea National Health and Nutrition Examination Survey (1998–2011). Diabetes Metab J 2014;38:35–43.
    1. World Health Organization. WHO Media Centre. Obesity and overweight: fact sheet 2018. Available at: . Accessed August 22, 2018.
    1. Segula D. Complications of obesity in adults: a short review of the literature. Malawi Med J 2014;26:20–4.
    1. Valencia WM, Stoutenberg M, Florez H. Weight loss and physical activity for disease prevention in obese older adults: an important role for lifestyle management. Curr Diab Rep 2014;14:539.
    1. Dietrich MO, Horvath TL. Limitations in anti-obesity drug development: the critical role of hunger-promoting neurons. Nat Rev Drug Discov 2012;11:675–91.
    1. Jang JK. Keumgueyoryak. Seoul: Daeseongmunhwasa; 1988.
    1. Abourashed EA, El-Alfy AT, Khan IA, et al. Ephedra in perspective—a current review. Phytother Res PTR 2003;17:703–12.
    1. Inchiosa MA. Concerning ephedra alkaloids for weight loss. Int J Obes 20052007;31:1481.
    1. Kim B-S, Song M-Y, Kim H. The anti-obesity effect of ephedra sinica through modulation of gut microbiota in obese Korean women. J Ethnopharmacol 2014;152:532–9.
    1. Kang JW, Nam D, Kim KH, et al. Effect of Gambisan on the inhibition of adipogenesis in 3T3-L1 adipocytes. Evid Based Complement Alternat Med 2013;2013:789067.
    1. Jo D. Effectiveness of Gambisan on weight loss in overweight and obese adults: a retrospective review of medical charts. Master's thesis. Kyung Hee University. 2016.
    1. Kwak HY, Kim JH, Seon JI, et al. The effects and adverse events of Gamiwolbigachultang on the changes of body composition and musculoskeletal pain in 28 overweight patients: A retrospective observational study. J Acupunct Res 2011;25:103–10.
    1. Yanovski SZ, Yanovski JA. Long-term drug treatment for obesity: a systematic and clinical review. JAMA J Am Med Assoc 2014;311:74–86.
    1. Park S, Nahmkoong W, Cheon C, et al. Efficacy and safety of taeeumjowi-tang in obese Korean adults: a double-blind, randomized, and placebo-controlled pilot trial. Evid Based Complement Alternat Med 2013;2013:498935.
    1. Park CY, Kim YS, Ryu MS, et al. A phase 3 double-blind, parallel-group, placebo-controlled trial of the efficacy and safety of sibutramine (Reductil) in the treatment of obese patients. Korean J Obes 2001;10:336–47.
    1. Park HS, Kim KS, Kim BT, et al. Double-blind, randomized, multi-center, comparative clinical trial of sibutramine mesilate with sibutramine hydrochloride for evaluating efficacy and safety in obese patients. Korean J Obes 2008;17:82–90.
    1. Korea Pharmaceutical Information Center. Herbal medicine sheet. Available at: . Accessed August 12, 2018.
    1. Korean Institute of Oriental Medicine (KIOM, the society of Korean medicine for obesity research). Korean Medicine Clinical Practice Guideline for Obesity. Daejeon: Elsevier; 2016.

Source: PubMed

3
Se inscrever