From the Journals

Frankincense extract may reduce disease activity in relapsing-remitting MS

 

Key clinical point: Standardized oral frankincense extract was safe, well tolerated, and potentially efficacious in patients with relapsing-remitting multiple sclerosis.

Major finding: The median number of monthly contrast-enhancing lesions was significantly reduced from 1.00 at baseline to 0.50 on treatment (P less than .0001).

Study details: The SABA phase 2a trial, an investigator-initiated, open-label, pilot study including 38 patients with RRMS.

Disclosures: The study was funded in part by Alpinia Laudanum Institute, which supplied the standardized frankincense extract at no charge. Individual authors reported competing interests with Alpinia Laudanum, Biogen, Sanofi Genzyme, Novartis, Merck Serono, and others.

Source: Stürner KH et al. J Neurol Neurosurg Psychiatry. 2018;89:330-8.

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New therapeutic option for relapsing-remitting MS?

Results of the SABA phase 2a trial suggest that frankincense could be a new therapeutic agent for mildly disabled young patients with RRMS who require long-term treatment, according to Dr. Francesco Patti.

In the study, administration of standardized oral frankincense extract significantly reduced the median number and volume of contrast-enhancing lesions and the number of new T2 lesions. The treatment also increased brain parenchymal volume and reduced the annualized relapse rate. While disability scores remained unchanged, measures of function and quality of life improved.

The treatment effects also appeared to be durable, based on the extension phase results.

Blood and immunologic findings suggested that the treatment was not toxic and that it exerted immunomodulatory activity by reduction of IL-17–producing CD8-positive T cells, as well as anti-inflammatory properties through inhibitory effects on 5-lipo-oxygenase, microsomial prostaglandin E2 synthase-1, LL-37, and nuclear factor-kB activities.

“This mechanism of action, attributing a role of these enzymes in neuroinflammation, might offer a new therapeutic approach,” he concluded in his editorial.

Francesco Patti, MD , is with the Multiple Sclerosis Hub Center, University of Catania (Italy). These comments are derived from his editorial ( J Neurol Neurosurg Psychiatry. 2018;89:327 ). Dr. Patti declared no competing interests related to the editorial.


 

FROM Journal of Neurology, Neurosurgery & Psychiatry

A standardized frankincense extract was safe, well tolerated, and potentially efficacious as an oral treatment in patients with relapsing-remitting multiple sclerosis (RRMS), according to results of a small, nonrandomized study.

Patients receiving the herbal treatment had significantly fewer contrast-enhancing lesions on MRI versus baseline in the study, which was published in the Journal of Neurology, Neurosurgery & Psychiatry.

A diagnosis form says multiple sclerosis. designer491/Thinkstock
Randomized, phase 2b or 3 trials should be initiated to evaluate the potentially beneficial effects of the treatment, said lead author Klarissa Hanja Stürner, MD, of the Institute of Neuroimmunology and Multiple Sclerosis at University Medical Center Hamburg-Eppendorf, (Germany), and her coinvestigators.

“Despite our encouraging results, it is difficult to forecast the efficacy of a standardized frankincense extract in RRMS,” Dr. Stürner and her colleagues wrote in their report on the study.

Boswellic acids, believed to be the active compound in frankincense, has been used as an anti-inflammatory substance for thousands of years in Eastern medicine, according to the study authors.

Frankincense extracts were safe and well tolerated in several small, randomized trials including patients with inflammatory or autoimmune diseases, they noted.

Dr. Stürner and her colleagues tested a standardized frankincense extract in the SABA phase 2a trial, an investigator-initiated, open-label, pilot study including 38 patients with RRMS.

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