Butterbur
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Butterbur Helped Migraines in DB: In a 4-month DB PC study of 245 migraine patients (2-6 attacks/month), migraine attack frequency was reduced by 48% for Petasites extract 75 mg bid (p = 0.0012 vs placebo), 36% for Petasites extract 50 mg bid (p = 0.127 vs placebo), and 26% for the placebo. The most frequently reported adverse reactions considered possibly related to treatment were mild gastrointestinal events, predominantly burping. Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Lipton RB, Gobel H, et al. Albert Einstein, Bronx, NY. Neurology. 2004 Dec 28;63(12):2240-4.

Butterbur Helped Migraines: In a reanalysis of data from a 3-month DB PC study of 60 migraine patients, 50 mg butterbur twice a day decreased attacks from 3.4 at baseline to 1.8 after 3 months (p = 0.0024) vs. from 2.9 to 2.6 for placebo. The responder rate (improvement of migraine frequency > or =50%) was 45% for butterbur vs. 15% for placebo. Butterbur was well tolerated. The first placebo-controlled trial of a special butterbur root extract for the prevention of migraine: reanalysis of efficacy criteria. Diener HC, Rahlfs VW, Danesch U. University of Essen, Germany. Eur Neurol. 2004;51(2):89-97.

Butterbur Helped Asthmatics as an Add-On to Inhaled Steroids: In a DB PC crossover study of 16 atopic asthmatic patients maintained on their constant dose of inhaled corticosteroids but given either twice daily for 1 week BB 25 mg or placebo (PL), with a 1-week washout period prior to each, adenosine monophosphate bronchoprovocation improved (P<0.05) with BB, 0.6 vs. -0.1 for placebo. Exhaled nitric oxide as change from baseline was reduced (P<0.05) with BB, -1.2 vs. 0.5 for placebo. Both serum eosinophil cationic protein and peripheral blood eosinophil count as change from baseline were also suppressed (P<0.05) with BB, -3.9  microg/L, -31 x106/L vs. PL, 3.3microg/L, 38 x106/L. Butterbur, a herbal remedy, confers complementary anti-inflammatory activity in asthmatic patients receiving inhaled corticosteroids. Lee DK, Haggart K, et al. University of Dundee, Scotland, UK. Clin Exp Allergy. 2004 Jan;34(1):110-4.

Butterbur Helps Hay Fever Symptoms: Butterbur one QID did as well an anti-histamine without drowsiness in good DB study. Swiss. Brit Med J 1/12/02 324:144

Butterbur Helped Allergic Rhinitis: In a 7-day DB PC study of 186 patients with intermittent allergis rhinitis, Butterbur Ze339 three times a day resulted in a significantly greater decrease in symptoms. Butterbur Ze339 for the treatment of intermittent allergic rhinitis: dose-dependent efficacy in a prospective, randomized, double-blind, placebo-controlled study. Schapowal A; Petasites Study Group.Landquart, Switzerland. Arch Otolaryngol Head Neck Surg. 2004 Dec;130(12):1381-6.

Butterbur No Benefit for Allergic Rhinitis in Study: Butterbur (Petasites hybridus) contains the active ingredient petasin, which exhibits antileukotriene and antihistamine activity. In a DB PC study of 35 grass pollen allergy sufferers with intermittent allergic rhinitis, 50 mg twice daily of butterbut There was no significant clinical efficacy of butterbur use vs placebo use on objective and subjective outcomes in IAR. Effects of butterbur treatment in intermittent allergic rhinitis: a placebo-controlled evaluation. Gray RD, Haggart K, et al. University of Dundee, Scotland. Ann Allergy Asthma Immunol. 2004 Jul;93(1):56-60 

Butterbur as Good as Fexofenadine for Allergic Rhinitis: In a 2-week DB PC crossover study of 16 patients with perennial allergic rhinitis and house dust mite sensitization were butterbut 50 mg twice daily did as well as fexofenadine 180 mg once daily. The maximum % peak nasal inspiratory flow fall from baseline after nasal AMP challenge was significantly attenuated (P<0.05) compared to PL (46), with BB (34) and FEX (39). The area under the 60-min time-response curve (%.min) was also significantly attenuated (P<0.05) compared to PL (1734), with BB (1052) and FEX (1194). There was also a significant reduction (P<0.05) in total nasal symptom score with BB (1.8) and FEX (1.8), compared to PL (2.8). A placebo-controlled evaluation of butterbur and fexofenadine on objective and subjective outcomes in perennial allergic rhinitis. Lee DK, Gray RD, et al. University of Dundee, Scotland, UK. Clin Exp Allergy. 2004 Apr;34(4):646-9.

Butterbur Helped Seasonal Allergic Rhinitis in DB: 20 patients in a DB PC crossover study for 2 weeks each.  In butterbur phase they received 50mg/d. Inhibits leukotriene synthesis. Butterbur, a herbal remedy, attenuates adenosine monophosphate induced nasal responsiveness in seasonal allergic rhinitis. Lee DK, Carstairs IJ, et al. Clin Exp Allergy. 2003 Jul;33(7):882-6

Butterbur as Good as Anti-histamine in Seasonal Allergic Rhinitis: Large DB 125 patients. 12 side-effects in 61 anti-histamine patients with 8 having drowsiness problems. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. Schapowal A; Petasites Study Group. BMJ. 2002 Jan 19;324(7330):144-6. Author notes that extracts of butterbur have been used in bronchial asthma, smooth muscle spasms, and headache.

Thomas E. Radecki, M.D., J.D.

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