Clinical evaluation of efficacy of Majoon Ushba and Roghane Hindi in the management of psoriasis: A randomized single-blind, placebo-controlled study

Abstract

Psoriasis is a common dermatological disease affecting up to 1–2% of the world's population. It is associated with both organic and psychosocial complications like psoriatic arthropathy, nephritis, infection, hyperuricemia, hypoproteinemia, depression, and stress, and is responsible for hindering patients’ daily activities. The present study was conducted to assess the safety and efficacy of two pharmacopeial Unani formulations (Majoon Ushba and Roghane Hindi) in the management of psoriasis on scientific parameters. Thirty diagnosed psoriasis patients, satisfying the inclusion criteria, were selected for a randomized, single-blind, placebo-controlled study in the Department of Moalajat (Medicine), National Institute of Unani Medicine, Bangalore. The patients were divided by the method of Random Table Numbers into test and control groups after obtaining informed consent. The experimental group comprised 20 patients to whom Majoon Ushba 5 g was administered orally twice daily and Roghane Hindi was applied locally twice daily. The control group comprised 10 patients who were given placebo drugs orally and topically. The duration of the trial was 8 weeks and follow-up was done fortnightly. The severity of psoriasis and efficacy of the drug was assessed by the Psoriasis Area and Severity Index (PASI) Scale. The results of both groups were compared and analyzed statistically. The study showed significant reduction in the PASI score in the test group (P < 0.01) as compared to placebo. No obnoxious side effects were observed in the test group: toxicological parameters were within normal limits even after 2 months of treatment. It was therefore concluded that Majoon Ushba and Roghane Hindi are safe and effective in the management of psoriasis

Current evidence on the effectiveness of systemic herbal medicine for psoriasis: A systematic review with meta-analysis

“…Note also that it says "Favours Placebo" to the left of the vertical line and "Favours Herbal" to the right of the vertical line. On the forest plot shown on Figure 2, the 95% confidence intervals of the two studies (Ho et al [46], Lone et al [48]) overlap 1, the 95% confidence intervals of the study (Ahmadi et al [43]) do not overlap 1. There is statistical significance at the meta-analysis level.…”

“…For example, in Figure 2, there are 9 out of 14 participants of herbal invention group show treatment efficacy, and there are 0 out of 14 participants of placebo control group show treatment efficacy in Ahmadi et al [43] study. The influence of each individual study on overall meta-analysis are weighted at 11.5%, 73.3% and 15.1% by Ahmadi et al [43], Ho et al [46] and Lone et al [48] respectively. The Risk Ratio (RR) effect measure, Mantel-Haenszel (M-H) statistical method and the Fixed Effect analysis model with 95% Confidence Interval used to perform the meta-analysis.…”

“…The 9 RCTs [43][44][45][46][47][48][49][50][51] Three studies, Ahmadi et al [43], Ho et al [46], Lone et al [48], included in the subgroup A meta-analysis ( Figure 2) and listed in the first column "study or subgroup". The individual study findings are displayed in this subgroup meta-analysis with binary outcomes (herbal intervention/placebo control).…”

“…In total, 9 RCTs [43][44][45][46][47][48][49][50][51][52] were included in the qualitative synthesis (Table 2) and 9 RCTs [43][44][45][46][47][48][49][50][51][52] were included in the meta-analysis (Figures 2-4). Regarding the effectiveness of herbal medication for psoriasis, 3 RCTs revealed that herbal medicine performed better than placebo control, 3 RCTs showed that the western drug competitor is superior than herbal intervention, 1 RCT showed the herbal medicine performed better than competitive herbal medicine, 2 RCTs suggested that herbal combined with other medication (Auricular or Acitretin) is better than herbal medicine alone.…”

“…A total 13 full text articles were retrieved for further evaluation, 2 were not a randomised controlled trial, 1 was not a herbal intervention. Data were extracted from the remaining 10 [43][44][45][46][47][48][49][50][51][52], Hegazi et al (2013) [52] study was excluded from the meta-analysis because it contains 4 intervention groups and therefore did not meet the inclusion criteria for this review.…”