And8.5

Andrographis Research

32 peer-reviewed studies · Evidence score: 8.5/10

Safety of Andrographis paniculata: A systematic review and meta-analysis

Worakunphanich W et al. • Pharmacoepidemiology and drug safety (2021)

Like other medicine, Andrographis paniculata can cause some AEs.

Incidence of serious AEs was very rare with the pooled incidence (95% CI) from RCTs of 0.02 per 1000 patients (0.0-0.5).
However, the incidence of nonserious AEs was considered very common with the pooled incidence (95% CI) from RCTs of 102.6 per 1000 patients (10.7-256.1), and the pooled incidence (95% CI) from intensive monitoring of 34.2 per 1000 patients (0.0-229.6).
Like other medicine, Andrographis paniculata can cause some AEs.

Meta-Analysisn=1,000

DOI

Andrographis paniculata for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis

Hu XY et al. • PLoS One (2017)

Andrographis paniculata significantly reduced cough severity and sore throat duration in acute upper respiratory infections.

Andrographis significantly improved cough symptoms vs placebo (SMD -0.39)
Sore throat severity and duration were significantly reduced
Well-tolerated with adverse event rates comparable to placebo

Meta-Analysisn=3,384

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Systematic review: the efficacy of herbal therapy in inflammatory bowel disease

Ng SC et al. • Alimentary pharmacology & therapeutics (2013)

Randomised controlled trials of herbal therapy for the treatment of IBD show encouraging results but studies remain limited and heterogenous.

Twenty-one randomised controlled trials (14 UC; 7 CD) including a total of 1484 subjects (mean age 41, 50% female) were analysed.
Randomised controlled trials of herbal therapy for the treatment of IBD show encouraging results but studies remain limited and heterogenous.
Larger controlled studies with stricter endpoints and better-defined patient groups are required to obtain more conclusive results on the use of CAM therapies in IBD.

Systematic Reviewn=1,484

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Herbal Medicines for the Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis

Iyengar P et al. • Nutrients (2024)

Research with larger scale and well-designed RCTs, manufacturing regulations, and education are needed.

In pooled analyses, when compared with placebo, clinical response rates were significantly higher for Indigo naturalis (IN) (RR 3.70, 95% CI 1.97-6.95), but not for Curcuma longa (CL) (RR 1.60, 95% CI 0.99-2.58) or Andrographis paniculata (AP) (RR 0.95, 95% CI 0.71-1.26).
There was a significantly higher rate of clinical remission for CL (RR 2.58, 95% CI 1.18-5.63), but not for AP (RR 1.31, 95% CI 0.86-2.01).
Higher rates of endoscopic response (RR 1.56, 95% CI 1.08-2.26) and remission (RR 19.37, 95% CI 2.71-138.42) were significant for CL.

Meta-Analysis

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The role of andrographolide as a potential anticancer agent against gastric cancer cell lines: a systematic review

Anis Amiera MA et al. • PeerJ (2024)

These studies indicate that andrographolide can hinder the cell cycle, suppress cell proliferation, alleviate oxidative stress, and induce apoptosis by prompting gastric cancer cells to undergo self-destruction, which is a crucial mechanism for controlling and eliminating cancerous growths.

These studies indicate that andrographolide can hinder the cell cycle, suppress cell proliferation, alleviate oxidative stress, and induce apoptosis by prompting gastric cancer cells to undergo self-destruction, which is a crucial mechanism for controlling and eliminating cancerous growths.
Further research warranted to confirm findings

Systematic Review

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Andrographolide, a diterpene lactone from Andrographis paniculata and its therapeutic promises in cancer

Islam MT et al. • Cancer letters (2018)

Among the model systems, cultured cell lines appeared as the most frequently (79.14%) used, followed by in vivo models using rodents, among others.

Among the model systems, cultured cell lines appeared as the most frequently (79.14%) used, followed by in vivo models using rodents, among others.
After careful consideration of the relevant evidence, we suggest that andrographolide can be one of the potential agents in the treatment of cancer in the near future.Copyright © 2018 Elsevier B.V.

Systematic Reviewn=139

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A Systematic Review on the Antimicrobial Activity of Andrographolide

Dafur GS et al. • Journal of microbiology and biotechnology (2024)

This review highlights the need for further research on andrographolide's antifungal activity, mechanisms of action, clinical safety, toxicity, and potential applications in antimicrobial resistance strategies.

The quality assessment revealed low bias risk in 11 out of 16 studies (78.57% to 92.86%), while the remaining five had medium bias risk (57.14% to 64.29%), indicating an overall acceptable quality of the studies.
Information on andrographolide's potential and effectiveness across various microorganisms is crucial.
Therefore, the purpose of this review was to synthesize the existing data on andrographolide's antimicrobial activity and assess its potential in combating antimicrobial resistance.

Systematic Reviewn=16

DOI

The effect of emerging nutraceutical interventions for clinical and biological outcomes in multiple sclerosis: A systematic review

Marx W et al. • Multiple sclerosis and related disorders (2020)

The existing literature provides preliminary support for the use of a number of nutraceutical interventions in MS.

The existing literature provides preliminary support for the use of a number of nutraceutical interventions in MS.
However, sufficiently powered long-term trials are required to expand the currently limited literature and to investigate unexplored nutraceuticals that may target relevant pathways involved in MS such as the gut microbiome and mitochondrial dysfunction.
Prospero ID: CRD42018111736.

Systematic Reviewn=31

DOI

Efficacy and safety of treatments in Familial Mediterranean fever: a systematic review

Demirkaya E et al. • Rheumatology international (2016)

Colchicine is an effective treatment in FMF.

The quality of the colchicine trials was low compared with the other drugs trials.
Safety was not clearly mentioned in the trials.
Colchicine is an effective treatment in FMF.

Systematic Reviewn=57

DOI

The role of dietary supplements in inflammatory bowel disease: a systematic review

Rossi RE et al. • European journal of gastroenterology & hepatology (2016)

In summary, attention to dietary factors such as curcumin, green tea and vitamins, including vitamins D and B12, appears to be beneficial and, if necessary, supplementation may be appropriate.

Zinc and iron should be supplemented in selected cases.
Probiotics (VSL#3) may reduce disease activity in IBD patients with pouchitis.
Complementary and alternative medicines are used by IBD patients and some studies have shown promising results.

Systematic Review

DOI

Systematic review of complementary and alternative medicine treatments in inflammatory bowel diseases

Langhorst J et al. • Journal of Crohn's & colitis (2015)

Complementary and alternative therapies might be effective for the treatment of inflammatory bowel diseases; however, given the low number of trials and the heterogeneous methodological quality of trials, further in-depth research is necessary.

Complementary and alternative therapies might be effective for the treatment of inflammatory bowel diseases; however, given the low number of trials and the heterogeneous methodological quality of trials, further in-depth research is necessary.
Further research warranted to confirm findings

Systematic Review

DOI

Andrographis paniculata for the treatment of upper respiratory infection: a systematic review by the natural standard research collaboration

Kligler B et al. • Explore (New York, N.Y.) (2006)

This systematic-review examined the effects of Andrographis.

Systematic review examining Andrographis efficacy
Further research warranted to confirm findings

Systematic Review

DOI

Efficacy and safety of AP-Bio®(KalmCold®) in participants with uncomplicated upper respiratory tract viral infection (common cold) - A phase III, double-blind, parallel group, randomized placebo-controlled trial

Raj JP et al. • Complementary therapies in medicine (2023)

Participants in both the AP-Bio® dose groups showed positive tendency towards resolution of URTI symptoms when compared with placebo on Day-3 but not on Day-5 and Day-7.

AP-Bio® 400 mg group (Mean Difference - MD [Standard Error - SE] = -3.85 [1.52]; 95% CI = -6.85, - 0.85; adjusted p = 0.034) and 200 mg group (MD [SE] = -3.74 [1.51]; 95% CI = -6.73, - 0.76; adjusted p = 0.038) had significantly lower score than placebo.
Participants in both the AP-Bio® dose groups showed positive tendency towards resolution of URTI symptoms when compared with placebo on Day-3 but not on Day-5 and Day-7.
Further research warranted to confirm findings

RCTn=331

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A double-blind, randomized, placebo-controlled study to assess the efficacy of Andrographis paniculata standardized extract (ParActin®) on pain reduction in subjects with knee osteoarthritis

Hancke JL et al. • Phytotherapy research : PTR (2019)

Overall, it can be concluded that ParActin® in 300 and 600 mg/day dosages were found to be effective and safe in reducing pain in individuals suffering from mild to moderate knee osteoarthritis.

Patients treated with 300 or 600 mg/day of ParActin® showed a significant reduction in pain at days 28, 56, and 84 compared with a placebo group.
WOMAC stiffness scores, physical function score, and the fatigue score showed a significant improvement in both ParActin®-treated groups compared with the placebo group.
At the end of the study, the quality of life (SF-36 questionnaire) and Functional Assessment of Chronic Illness Therapy (FACIT) scores showed significant improvements in both ParActin®-treated groups compared with the placebo group.

RCTn=103

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Combination of Activating Blood Circulation and Detoxifying Chinese Medicines Played an Anti-Inflammatory Role in Unstable Angina Patients after Percutaneous Coronary Intervention: A Multicenter, Open-Labeled, Randomized Controlled Trial

Ma XJ et al. • Chinese journal of integrative medicine (2021)

The combination of Guanxin Danshen Dropping Pill and Andrographis tablet exert significant anti-inflammatory effect on UA patients, which is superior to single Guanxin Danshen Dropping Pill. (Registration No.

The combination of Guanxin Danshen Dropping Pill and Andrographis tablet exert significant anti-inflammatory effect on UA patients, which is superior to single Guanxin Danshen Dropping Pill. (Registration No.
ChiCTR-TRC-13004072).
Further research warranted to confirm findings

RCTn=154

DOI

The effect of Andrographis paniculata water extract on palliative management of metastatic esophageal squamous cell carcinoma-A phase II clinical trial

Chiu PW et al. • Phytotherapy research : PTR (2023)

Phytotherapy Research

The treatment effect of AP also contributed to the shift of the overall structure of gut microbiota for ESCC patients towards those of healthy individuals.
The significance of this study is the establishment of AP as a safe and effective palliative treatment for patients with squamous cell carcinoma of the esophagus.
To the best of our knowledge, this is the first clinical trial of AP water extract in esophageal cancer patients demonstrating its new medicinal use.

RCTn=30

DOI

Efficacy of Andrographis paniculata spray in acute pharyngitis: A randomized controlled trial

Okonogi R et al. • Drug discoveries & therapeutics (2023)

A. paniculata spray is safe and highly efficacious in treating acute viral pharyngitis and can reduce symptoms more rapidly than a positive control spray.

Results revealed a significant reduction in the severity of all signs and symptoms in both groups (p < 0.05).
The duration of treatment response in the A. paniculata spray group was 1.9 ± 0.7 days compared to 2.5 ± 1.2 days in the chamomile spray group (p = 0.049).
No adverse events were noted in either group.

RCTn=60

DOI

Andrographis paniculata extract (HMPL-004) for active ulcerative colitis

Sandborn WJ et al. • The American journal of gastroenterology (2013)

Patients with mildly to moderately active ulcerative colitis treated with A. paniculata extract (HMPL-004) at a dose of 1,800 mg daily were more likely to achieve clinical response than those receiving placebo.

In total, 45 and 60% of patients receiving A. paniculata 1,200 mg and 1,800 mg daily, respectively, were in clinical response at week 8, compared with 40% of those who received placebo (P=0.5924 for 1,200 mg vs. placebo and P=0.0183 for 1,800 mg vs. placebo).
In all, 34 and 38% of patients receiving A. paniculata 1,200 mg and 1,800 mg daily, respectively, were in clinical remission at week 8, compared with 25% of those who received placebo (P=0.2582 for 1,200 mg vs. placebo and P=0.1011 for 1,800 mg vs. placebo).
Adverse events developed in 60 and 53% of patients in the A. paniculata 1,200 mg and 1,800 mg daily groups, respectively, and 60% in the placebo group.

RCTn=224

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Efficacy of Andrographis paniculata extract treatment in mild to moderate COVID-19 patients being treated with favipiravir: A double-blind, randomized, placebo-controlled study (APFaVi trial)

Siripongboonsitti T et al. • Phytomedicine : international journal of phytotherapy and phytopharmacology (2023)

APE treatment did not demonstrate additional clinical and virological benefits in patients with mild to moderate COVID-19 being treated with favipiravir.

Non-deterioration of WHOCPS scores on day 4 was 98.63% versus 97.26% of patients in the APE-FPV and placebo-FPV groups (p = 1.000).
The oxygen supplemental was 4.11% in the placebo-FPV group.
APE treatment did not demonstrate additional clinical and virological benefits in patients with mild to moderate COVID-19 being treated with favipiravir.

RCTn=19

DOI

A validated LC-MS/MS method for clinical pharmacokinetics and presumptive phase II metabolic pathways following oral administration of Andrographis paniculata extract

Songvut P et al. • Scientific reports (2023)

This rct examined the effects of Andrographis.

The disposition kinetics demonstrated that major diterpenoids could enter into systemic circulation, but they are mostly biotransformed (phase II) into conjugated glucuronide and sulfate metabolites.
These metabolites are predominantly found in plasma and then extremely eliminated, in part through urinary excretion.
The successful application of this analytical method supports its suitable uses in further clinical benefits after oral administration of A. paniculata.

RCT

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