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. 2011:4:291-6.
doi: 10.2147/CEG.S26297. Epub 2011 Dec 12.

Rikkunshito, a traditional Japanese medicine, suppresses cisplatin-induced anorexia in humans

Tetsuro Ohno  1 , Mitsuhiro Yanai, Hiroyuki Ando, Yoshitaka Toyomasu, Atsushi Ogawa, Hiroki Morita, Kyoichi Ogata, Erito Mochiki, Takayuki Asao, Hiroyuki Kuwano
Affiliations

Rikkunshito, a traditional Japanese medicine, suppresses cisplatin-induced anorexia in humans

Tetsuro Ohno et al. Clin Exp Gastroenterol. 2011.

Abstract

Background: The aim of this study was to investigate the effects of Rikkunshito on ghrelin secretion and on cisplatin-induced anorexia in humans.

Methods: The study was performed as a crossover design, and ten unresectable or relapsed gastric cancer patients were randomly divided into two groups. Group A (n = 5) was started on Rikkunshito (2.5 g three times daily, orally) from the first course of chemotherapy and followed by a second course without Rikkunshito. A treatment with reversed order was performed for Group B (n = 5). All patients received combined chemotherapy with S-1 plus cisplatin. The primary endpoint was the amount of oral intake, and the categories of scales of anorexia, nausea, and vomiting; secondary endpoints included the plasma concentration of acylated ghrelin.

Results: In the Rikkunshito-on period, no decrease of the plasma concentration of acylated ghrelin induced by cisplatin was observed. The average oral intake in the Rikkunshito-on period was significantly larger than that in the Rikkunshito-off period, and the grade of anorexia was significantly lower in the Rikkunshito-on period than in the Rikkunshito-off period.

Conclusion: Rikkunshito appeared to prevent anorexia induced by cisplatin, resulting in effective prophylactic administration of chemotherapy with cisplatin, and patients could continue their treatments on schedule.

Keywords: Rikkunshito; anorexia; cisplatin; ghrelin; stomach cancer.

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Figures

Figure 1
Figure 1
Crossover study design. Patients in group A initially took oral Rikkunshito before every meal for 3 weeks (on treatment). After a rest period of 2 weeks, Rikkunshito was discontinued for 3 weeks (off treatment). Conversely, patients in group B initially were off treatment for 3 weeks and then on treatment for 3 weeks after the rest period.
Figure 2
Figure 2
Plasma concentration of acylated ghrelin. In the Rikkunshito-on period (Rikkunshito [+]), no decrease of plasma concentration of acylated ghrelin was observed before and after administration. Abbreviation: NS, not significant.
Figure 3
Figure 3
Comparison of the amount of oral intake. The average oral intake in the Rikkunshito-on period was significantly larger than that in the Rikkunshito-off period. Note: *P = 0.0496.
Figure 4
Figure 4
Comparison of the grade of anorexia. The grade of anorexia (0–4) was significantly lower in the Rikkunshito-on period than in the Rikkunshito-off period. Note: *P = 0.0441.
Figure 5
Figure 5
Comparison of the grade of nausea. The difference in the grade of nausea (0–3) was not significant. Abbreviation: NS, not significant.
Figure 6
Figure 6
Comparison of the grade of vomiting. The difference in the grade of vomiting (0–4) was not significant. Abbreviation: NS, not significant.
Figure 7
Figure 7
Kaplan–Meier curves of time to treatment failure. The number of cases of treatment failure in the Rikkunshito-off period was nine, whereas that in the Rikkunshito-on period was five. Abbreviation: NS, not significant.
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