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Randomized Controlled Trial
. 2020 Nov 5;15(11):e0241337.
doi: 10.1371/journal.pone.0241337. eCollection 2020.

Efficacy and safety of short-term therapy with indigo naturalis for ulcerative colitis: An investigator-initiated multicenter double-blind clinical trial

Kan Uchiyama  1 , Shinichiro Takami  1 , Hideo Suzuki  2 , Kiyotaka Umeki  3 , Satoshi Mochizuki  4   5 , Nobushige Kakinoki  6 , Junichi Iwamoto  7 , Yoko Hoshino  8 , Jun Omori  9 , Shunji Fujimori  9 , Akinori Yanaka  10 , Yuji Mizokami  2 , Toshifumi Ohkusa  1   11
Affiliations
Randomized Controlled Trial

Efficacy and safety of short-term therapy with indigo naturalis for ulcerative colitis: An investigator-initiated multicenter double-blind clinical trial

Kan Uchiyama et al. PLoS One. .

Abstract

Introduction: Indigo naturalis (IN) is a blue pigment extracted from Assam indigo and other plants and has been confirmed to be highly effective for ulcerative colitis (UC) treatment in several clinical studies.

Objective: We conducted a multicenter double-blind study to confirm the efficacy and safety of short-term IN administration.

Methods: A multicenter, randomized controlled trial was conducted between December 2015 and October 2018 in our facilities. Forty-six patients with mild to moderate active UC (Lichtiger index: 5-10) were randomly assigned to the IN group or the placebo group and received 5 capsules (500 mg) twice a day for 2 weeks. We investigated the efficacy according to blood tests and the Lichtiger index before and after administration, and we also examined adverse events.

Results: The analysis included 42 patients (20 males, 22 females) with an average age of 45 years. Nineteen patients were assigned to the placebo group, and 23 were assigned to the IN group. After treatment administration, in the placebo group, no change in the Lichtiger index was observed (7.47 to 6.95, p = 0.359), and hemoglobin was significantly reduced (12.7 to 12.4, p = 0.031), while in the IN group, the Lichtiger index (9.04 to 4.48, p = 0.001) and albumin (4.0 to 4.12, p = 0.022) improved significantly. Mild headaches were observed in 5 patients and 1 patient in the IN and placebo groups, respectively.

Conclusions: Short-term administration of IN is highly effective without serious adverse events such as pulmonary hypertension or intussusception and may prevent the occurrence of serious adverse events.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The research flow diagram.
IN: indigo naturalis.
Fig 2
Fig 2. Individual changes in the Lichtiger index before and after the intervention.
IN: indigo naturalis; LI: Lichtiger index.
Fig 3
Fig 3. The average change in the Lichtiger index before and after the intervention.
Fig 4
Fig 4. Comparisons of response and marked response rates.
IN: indigo naturalis.
Fig 5
Fig 5. Survey results 24 weeks after the start of the research.
IN: indigo naturalis; LI: Lichtiger index.
See this image and copyright information in PMC

References

    1. Sugimoto S, Naganuma M, Kanai T. Indole compounds may be promising medicines for ulcerative colitis. J Gastroenterol. 2016; 51:853–861. 10.1007/s00535-016-1220-2 - DOI - PubMed
    1. Sugimoto S, Naganuma M, Kiyohara H, Arai M, Ono K, Mori K, et al. Clinical Efficacy and Safety of Oral Qing-Dai in Patients with Ulcerative Colitis: A Single-Center Open-Label Prospective Study. Digestion. 2016; 93:193–201. 10.1159/000444217 - DOI - PubMed
    1. Suzuki H, Kaneko T, Mizokami Y, Narasaka T, Endo S, Matsui H, et al. Therapeutic efficacy of the Qing Dai in patients with intractable ulcerative colitis. World J Gastroenterol. 2013; 19: 2718–2722. 10.3748/wjg.v19.i17.2718 - DOI - PMC - PubMed
    1. Yoshimatsu Y, Naganuma M, Sugimoto S, Tanemoto S, Umeda S, Fukuda T, et al. Development of an Indigo Naturalis Suppository for Topical Induction Therapy in Patients with Ulcerative Colitis. Digestion. 2019; 25:1–7. 10.1159/000501152 - DOI - PubMed
    1. Fukunaga K, Hida N, Ohnishi K, Ohda Y, Yoshida K, Kusaka T, et al. A Suppository Chinese Medicine (Xilei-san) for Refractory Ulcerative Proctitis: A Pilot Clinical Trial. Digestion. 2007; 75:146–147. 10.1159/000106755 - DOI - PubMed

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