A new clinical trial on echinacea in children, published last month in the Journal of the American Medical Association, found that echinacea failed to reduce the severity or duration of upper respiratory tract infections in children ages 2 to 11. ?Clearly, the echinacea failed based on the hypothesis of the study, which is duration and severity of symptoms,? said Mark Blumenthal, executive director, American Botanical Council.
Press coverage of the study has focused on this failure, as well as a higher than expected incidence of rash as a side effect among children in the study who took echinacea compared with placebo. But Blumenthal argued that the study?s results, though disappointing, also contained some positive findings. The most important of these, he said, is the finding that echinacea use led to a reinfection rate significantly lower for the echinacea group than the placebo group. The researchers conjectured that, though the echinacea may have been given too late to provide relief for the first infection, it did provide a ?window of protection? for subsequent infections. ?Anybody who has a 2- to 11-year-old kid, as well as any physician who is a pediatrician, would want to know about these findings,? Blumenthal said.
Retailers will certainly field new questions about echinacea for children as a result of the study, and this tertiary finding of reduced reinfection is perhaps the most compelling reason to recommend echinacea. Consumers may also have questions about the incidence of rash in the echinacea group?7.1 percent, versus 2.7 percent in the placebo group.
According to Blumenthal, the reported incidence of rash is higher by a factor of 10 than in previous echinacea studies. This finding may have to do with the way the echinacea compound used in the current study was produced, Blumenthal said. The compound used, produced by Madaus AG of Germany, is not sold in the United States. ?The results of this trial relate only to the preparation used in this trial, and should not be attributed or extended to other preparations,? Blumenthal said.
The compound used in the study was prepared from the aerial parts of the plant, picked after flowering, extracted in alcohol. ?This is a special preparation not found in the United States,? Blumenthal said. He speculated that the incidence of rash may be a result of pollens found in the preparation, whereas most echinacea compounds sold in the United States are made from the root of the plant, which contains little or no pollen.
Finally, the study methodology may also have had an effect on the outcome. ?The research was based on logs kept by parents observing their children?s symptoms, which is not as accurate as self-reporting,? Blumenthal said. ?In addition, there may have been a lag time from the initial onset of symptoms to the time the echinacea was administered, and that lag time may have had an adverse effect on efficacy.?
Though the study was clearly not the vote of confidence echinacea supporters would have liked to see, it was also clearly not as negative as reports in the mainstream press would suggest. In fact, the finding of reduced future infections provides researchers with a positive opportunity for further study.
Natural Foods Merchandiser volume XXV/number 1/p. 9