A single arm phase II study of a Far-Eastern traditional herbal formulation (sho-sai-ko-to or xiao-chai-hu-tang) in chronic hepatitis C patients Journal Article


Authors: Deng, G.; Kurtz, R. C.; Vickers, A.; Lau, N.; Yeung, K. S.; Shia, J.; Cassileth, B.
Article Title: A single arm phase II study of a Far-Eastern traditional herbal formulation (sho-sai-ko-to or xiao-chai-hu-tang) in chronic hepatitis C patients
Abstract: Ethnopharmacological relevance: Hepatitis C is a major public health problem internationally. Many patients cannot benefit from the current treatment regimen (interferon/ribavirin combinations) due to its side effects or ineffectiveness. Xiao-Chai-Hu-Tang or Sho-sai-ko-to (SST), a compound of seven botanical extracts used for liver diseases traditionally in East Asia, was shown to reduce transaminases and the incidence of hepatocellular carcinoma in hepatitis B patients. We conducted a phase II trial of SST in hepatitis C patients who were not candidates for interferon-based therapy to determine whether this agent is worthy of further study. Materials and Methods: Twenty four chronic hepatitis C patients received SST at 2.5 g per os (p.o.) three times daily (t.i.d.) for 12 months. Liver function, hepatitis C virus (HCV) viral load and liver biopsy histology were assessed before and after the intervention. Results: Improvement of aspartate aminotransferase (AST) was observed in 16 (67%) of study participants. Improvement of alanine aminotransferase (ALT) was seen in 18 (75%) patients. Viral load response was mixed, with 7 patients showing reductions, 10 increases and 7 indeterminate due to assay limitations. Among the 9 (38%) subjects who showed improvement per Knodell's histology activity index (HAI) scores in paired comparison of pre- and post-treatment liver biopsy (the primary endpoints of the study), 5 (21%) showed an improvement of 2 points or greater, meeting the pre-defined criteria for "response. Conclusions: Sho-sai-ko-to (SST or Xiao Chai Hu Tang) may improve liver pathology in selected hepatitis C patients who are not candidates for interferon based treatment. Larger, controlled studies of this botanical formulation may be warranted. © 2011 Elsevier Ireland Ltd.
Keywords: hepatitis c; liver biopsy; kampo medicine; sho-sai-ko-to; traditional chinese medicine; xiao-chai-hu-tang
Journal Title: Journal of Ethnopharmacology
Volume: 136
Issue: 1
ISSN: 0378-8741
Publisher: Elsevier Ireland Ltd.  
Date Published: 2011-06-14
Start Page: 83
End Page: 87
Language: English
DOI: 10.1016/j.jep.2011.04.008
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 23 June 2011" - "CODEN: JOETD" - "Source: Scopus"
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MSK Authors
  1. Barrie R Cassileth
    198 Cassileth
  2. Gary E Deng
    77 Deng
  3. Jinru Shia
    719 Shia
  4. Andrew J Vickers
    880 Vickers
  5. Robert C Kurtz
    196 Kurtz
  6. Kwokwai Yeung
    36 Yeung