Kampo medicine bukuryoingohangekobokuto and ninjin'yoeitoyoeito as supportive care for management of anorexia and tightness of the esophagus in advanced esophageal cancer: A case report

Takayama, Shin; Ishii, Tadashi

doi:10.1016/j.explore.2022.02.007

Cited by 2 publications

(5 citation statements)

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“…Table 4 presents the list of clinical studies and Table 5 presents the list of case reports of NYT according to the search strategy. Five randomized clinical trials (RCT) [59][60][61][62][63], four observational studies [64][65][66][67], and 12 case reports were searched [68][69][70][71][72][73][74][75][76][77][78][79][80]. Herein, we summarize the findings of clinical studies on NYT.…”

Section: Clinical Results and Applications From Clinical Trials And C...mentioning

confidence: 99%

“…Takayama et al reported cases of anorexia during the treatment of malignant melanoma and esophageal cancer. In both cases, anorexia improved after the administration of NYT [63, 64]. Aomatsu et al reported the supportive role of NYT on postoperative weakness or during anticancer treatment in colon cancer [65, 66].…”

Section: Clinical Results and Applications From Clinical Trials And C...mentioning

confidence: 99%

“…Takayama et al reported cases of anorexia during the treatment of malignant melanoma and esophageal cancer. In both cases, anorexia improved after the administration of NYT [63,64]. Aomatsu 2005 [61] Abbreviation: AD, Alzheimer's disease; COPD, chronic obstructive pulmonary disease; Hb, hemoglobin; NYT, ninjin'yoeito; RCT, randomized controlled trial.…”

Section: Cancer Treatment Supportmentioning

confidence: 99%

“…2022 [64] N/A Patients with colorectal cancers NYT was administered for postoperative weakness and it supported quality of life.…”

Section: Publication Year [Reference]mentioning

confidence: 99%

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Review of frequently used Kampo prescriptions: Part 4, Ninjin'yoeito

Takayama,

Michihara,

Kimura

et al. 2023

Traditional & Kampo Medicine

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BackgroundThe source of ninjin'yoeito (NYT) is considered the ‘Formulary of Bureau of Taiping People's Welfare Pharmacy’, written around 1241–52 AD. NYT is used to treat patients with chronic fatigue, malaise with qi deficiency, and exhaustion of all five parenchymatous viscera with difficulty in recovering.Key FindingsNYT formula consists of 12 crude drugs. NYT extract for medical use is covered by the National Health Insurance system of Japan for convalescence after recovery from diseases, fatigue and malaise, anorexia, perspiration during sleep, cold limbs, and anemia. Studies have shown clinical effects of NYT: treatment of anemia, cancer treatment support, frailty, cognitive dysfunction, apathy, fatigue/malaise, anorexia, and lung diseases. Preclinical studies support clinical studies; activating ghrelin‐neuropeptide Y pathway‐mediated appetite‐enhancing effects, inhibiting muscle volume loss through the Akt/mTOR pathway‐mediated hyperphosphorylation of 4E‐BP1 and FoxO1‐mediated Atrogin‐1, suppressing the hypothalamic–pituitary–adrenal axis by downregulating the sympathetic‐adrenal‐medullary axis and GABA neurons for improving sociability, promoting recovery from skeletal muscle atrophy through the activation of PGC‐1α, hematopoiesis‐promoting effects, and increasing the number of immune cells in immunocompromised models. The incidence of adverse events of NYT was reported as 3.09 or 2.03%. The most significant adverse effects of NYT are gastrointestinal disorders.ConclusionRecently, NYT has been widely used to treat several symptoms and conditions under the National Health Insurance System of Japan. Clinical studies showed the efficacy of NYT to treat anemia, frailty, cognitive dysfunction, anorexia, apathy, and fatigue/malaise, as well as for long‐term cancer treatment support. The pharmacological mechanisms supporting its effects are also being reported.

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Section: Clinical Results and Applications From Clinical Trials And C...mentioning

confidence: 99%

Section: Clinical Results and Applications From Clinical Trials And C...mentioning

confidence: 99%

“…Takayama et al reported cases of anorexia during the treatment of malignant melanoma and esophageal cancer. In both cases, anorexia improved after the administration of NYT [63,64]. Aomatsu 2005 [61] Abbreviation: AD, Alzheimer's disease; COPD, chronic obstructive pulmonary disease; Hb, hemoglobin; NYT, ninjin'yoeito; RCT, randomized controlled trial.…”

Section: Cancer Treatment Supportmentioning

confidence: 99%

“…2022 [64] N/A Patients with colorectal cancers NYT was administered for postoperative weakness and it supported quality of life.…”

Section: Publication Year [Reference]mentioning

confidence: 99%

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Review of frequently used Kampo prescriptions: Part 4, Ninjin'yoeito

Takayama,

Michihara,

Kimura

et al. 2023

Traditional & Kampo Medicine

Self Cite

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“…The application of Kampo medicines, including ginseng, such as rikkunsito (RKT), has been reported in the treatment of anorexia as a side effect of cancer treatment ( Yoshiya et al, 2020 ). We previously reported long-term survival and improvement in quality of life in patients with advanced cancer, including pancreatic cancer, brain cancer, and esophageal cancer, which was supported with Kampo medicines ( Shimizu et al, 2021a ; Shimizu et al, 2021b ; Suzuki et al, 2021 ; Takayama and Ishii, 2022 ). Ninjin’yoeito (NYT) allows recovery from anorexia with frailty, and bukuryoingohangekobokuto (BRGHT) is used for persistent nausea with anxiety.…”

Section: Introductionmentioning

confidence: 80%

Case Report: Prolonged Anorexia With Nausea Caused by Immune Checkpoint Inhibitors for Malignant Melanoma Treated Using Kampo Medicines Bukuryoingohangekobokuto and Ninjin’yoeito

2022

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Immune checkpoint inhibitors (ICIs) are indicated for several cancers, including malignant melanoma. Anorexia and nausea resulting in malnutrition are side effects of ICIs. In such cases, conventional drugs are used for symptom relief, but the symptoms may persist. We report a case of advanced malignant melanoma with prolonged anorexia and nausea, which occurred after nivolumab administration, and was successfully treated using Kampo medicines. A 75-year-old man with nasal bleeding visited our hospital. A nasal scope revealed an obstructive tumor in the left nasal concha. Tissue biopsy showed malignant melanoma, and computed tomography showed metastasis to the liver and bone. Thus, the patient was diagnosed with stage IV malignant melanoma. He received radiotherapy (30 Gy) and nivolumab with ipilimumab four times, followed by nivolumab administration alone. During the administration of nivolumab, he complained of severe anorexia and nausea, with a numeric rating scale (no symptoms, 0; severe symptoms, 10) score of 10. He could not consume food because of these symptoms, even after nivolumab administration was discontinued. His blood pressure was 92/59 mmHg, his performance status (PS; no fatigue, 0; bedridden or disabled, 4) was 4, and his body weight gradually decreased from 60 to 39 kg in a month. The patient showed malnutrition and dehydration and experienced anxiety and depression. Nivolumab was terminated, and conventional symptomatic drugs were prescribed, but the symptoms persisted. We then prescribed 9.0 g/day of ninjin’yoeito (TJ-108, Tsumura and Co.) to allow recovery from anorexia and subsequently added bukuryoingohangekobokuto (TJ-116, Tsumura and Co.) to treat the persistent nausea. After treatment with these two Kampo medicines, the patient’s appetite gradually recovered. Along with the recovery of nutritional status, his PS improved to 0, his anxiety and depressive state improved, and his body weight increased to 60 kg. The patient remained in good condition without cancer recurrence. The patient’s clinical course shows the usefulness of Kampo medicine as supportive care for symptom relief and maintenance of nutritional and mental status during cancer treatment.

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Kampo medicine bukuryoingohangekobokuto and ninjin'yoeitoyoeito as supportive care for management of anorexia and tightness of the esophagus in advanced esophageal cancer: A case report

Cited by 2 publications

References 16 publications

Review of frequently used Kampo prescriptions: Part 4, Ninjin'yoeito

Review of frequently used Kampo prescriptions: Part 4, Ninjin'yoeito

Case Report: Prolonged Anorexia With Nausea Caused by Immune Checkpoint Inhibitors for Malignant Melanoma Treated Using Kampo Medicines Bukuryoingohangekobokuto and Ninjin’yoeito

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