Plant-based ointments versus usual care in the management of chronic skin diseases: a comparative analysis on outcome and safety.

Abstract

OBJECTIVES:

To assess the outcome and safety of plant-based ointments versus usual care in the management of chronic skin diseases.

METHODS:

Prospective mono-centric comparative analysis. Patients were recruited at an outpatient dermatology clinic and treated with plant-based ointments or care as usual. Main outcome criterion was the response rate, defined as the proportion of patients experiencing 'complete recovery' or 'major improvement' at 6, 12 and 24 months. Secondary outcome criteria were quality of life (SF-12 and EQ-5D), patient satisfaction and safety of treatment.

RESULTS:

A total of 112 patients with chronic skin diseases were evaluated of which 44 were treated with plant-based ointments (PO) and 68 received usual care (UC). The majority of patients suffered from psoriasis (PO: 50%; UC: 56%) or eczema (PO: 41%; UC: 32%) and were treated with homoeopathic topical ointments containing mahonia or cardiospermum or usual care creams containing calcipotriene and corticosteroids. The only significant difference in baseline status between the two groups was in disease severity score (PO: 1.8±0.7 versus UC: 2.4±0.8, p=0.0004). After two years, the main outcome of responders to treatment was 52.3% (95%-CI: 36.1-64.9) in the ointment and 41.2% (95%-CI: 20.4-42.2) in the UC group. Change in SF-12 (2 years compared to baseline), adjusted for baseline disease severity, was not significantly different between both groups; PO: 5.4 (95%-CI: 3.4-7.3) versus UC: 3.2 (95%-CI: 1.5-4.9). The adjusted EQ-5D was found to be significantly different between the two groups after two years, in favour of the ointment group; PO: 0.113 (95%-CI: 0.052-0.174) and UC: -0.008 (95%-CI: -0.055-0.038). Other secondary outcome parameters such as patient satisfaction and number of adverse drug reactions were comparable.

CONCLUSIONS:

The outcome of this study suggests at least therapeutic equivalence between plant-based ointments and usual care management of chronic skin diseases. As this non-randomised study was open to selection and other bias, further rigorous studies are needed to demonstrate the effectiveness of these topical products.

• Authors: Miek C Jong, Ulrike Ermuth, Matthias Augustin
• Journal: Complementary therapies in medicine (Complement Ther Med) Vol. 21 Issue 5 Pg. 453-9 (Oct 2013) ISSN: 1873-6963 [Electronic] Scotland
• PMID: 24050579 (Publication Type: Clinical Trial, Comparative Study, Journal Article)
• Copyright: Copyright © 2013 Elsevier Ltd. All rights reserved.

Chemical References

• Ointments
• Plant Extracts

Topics

• Adult
• Chronic Disease
• Female
• Homeopathy (methods)
• Humans
• Male
• Middle Aged
• Ointments (administration & dosage, adverse effects)
• Patient Satisfaction
• Plant Extracts (administration & dosage, adverse effects)
• Quality of Life
• Skin Diseases (drug therapy)
• Surveys and Questionnaires
• Treatment Outcome