Doctor: NSAIDs Are Not the Only Option

CHICAGO—For the multitude of Americans with inflammatory conditions, non-steroidal anti-inflammatory drugs (NSAIDs) come with considerable side effects—namely in the gastrointestinal (GI) and renal systems. But some botanical extracts act on the same anti-inflammatory enzyme pathways without the associated side effects. David Brady, ND, DC, CCN, DACBN, discussed emerging science behind one such extract, flavocoxid, at the Ninth Annual Scientific Symposium, presented by the Natural Health Research Institute (NHRI) and the American Nutrition Association. NOW Foods and Protocol For Life Balance® sponsored the Oct. 31 event.

"The chronic use of NSAID medications has been linked to increased intestinal permeability and inflammation in arthritis. For people who need constant treatment, they really don’t have a great place to go without side effects," Dr. Brady said, explaining NSAIDs are not consumers' only option. "In reality, in the herbal realm, there are a lot of botanicals that act on the same enzyme pathways, like ginger, curcumin, onion, garlic and boswellia."

Dr. Brady, vice provost, health sciences, University of Bridgeport, CT, presented research on flavocoxid, a blend of Scutellaria baicalensis and Acacia catechu botanical extracts. The ingredient is marketed under the pharmaceutical Limbrel.

To develop flavocoxid, researchers screened more than 1200 herbs, narrowing it down to 22 extracts. After more robust toxicology studies, "Scientists identified the main therapeutic active ingredients, and then came up with proprietary extraction methods to pull out these actives."

With two primary actives, baicalin and catechin, the extract has COX-1, COX-2, and 5-LOX activity, while many compounds only act on a single inflammation mechanism. "Instead of using an agent like NSAID, that is powerful against one pathway, you're using a smaller hammer across a broader spectrum," Dr. Brady explained, noting the extract's strong antioxidant profile is an added boost.

Flavocoxid has been found as effective as NSAIDs to reduce pain and stiffness, while improving mobility, in osteoarthritis (OA) patients. The extract also offers a better safety profile, according to data.

In the multi-center, open-label Gauging OA with Limbrel (GOAL) study, researchers from Primus Pharmaceuticals, Scottsdale, AZ, found "flavocoxid demonstrated significant efficacy in the management of OA in multiple patient types and displayed significant potential for reducing the possibility of adverse GI side-effects and use of gastroprotective agents associated with more traditional OA medications."  More than 1,067 patients at 41 centers took flavocoxid, 500 mg BID for 60 days (Curr Med Res Opin. 2010 May;26(5):1055-63.). Doctors recorded visual analog scale (VAS) improvements in patients, with moderate-to-severe subjects having the greatest improvement. Importantly, 90 percent patients who had previously halted NSAID use due to GI discomfort tolerated flavocoxid well; its use resulted in a more than 30-percent reduction in gastroprotective medicines.

Botanical ingredients such as flavocoxid are paving the way for herbal acceptance in the medical field.

"We understand botanicals’ pharmacognosy; they are not a mystery," Dr. Brady said. "People who ask where the science is haven’t looked."