Two herbal therapies get a second chance
Would you give arsenic to someone you love?
Medicinal preparations containing arsenic have been in medical use for more than 2,000 years. One hundred years ago, arsenic-based therapies were used in the United States and Europe for leukemia therapy and for infections, but they were later replaced by modern chemotherapy and antibiotics.
Recently, however, interest in arsenic-based therapy was revived by reports of anti-leukemic activity of some traditional Chinese preparations upon discovering that the active ingredient was arsenic trioxide.
The Food and Drug Administration has granted approval for arsenic trioxide (Trisenox) for patients with acute promyelocytic leukemia (APL) to be marketed by Cell Therapeutics. Development of Trisenox moved quickly with FDA approval forthcoming only three years after commencement of clinical trials. During clinical study, 70% of patients had remission of their leukemia and met the study-defined criteria for "response." The median time to remission was 51 days. Arsenic trioxide converts immature cancerous white blood cells into normal white blood cells in a manner similar to that of all trans-retinoic acid. (For more details, see the FDA Talk Paper at www.fda.gov/bbs/topics/ANSWERS/ANS01040.html.)
St. John’s Wort, ever popular in the press, appears again, this time in the British Medical Journal, which states that the supplement should be considered for first-line therapy in patients with mild to moderate depression.1 The article is based on a study in Germany involving more than 300 patients with depression.
Patients were randomized to receive St. John’s Wort extract or imipramine. Results show that the two therapies are therapeutically equivalent. Additionally, a smaller percentage of patients receiving St. John’s Wort experienced adverse events than did those receiving imipramine.
Reference
1. Woelk H. Comparison of St John’s wort and imipramine for treating depression: Randomised controlled trial. BMJ 2000; 321:536-539.
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