Butterbur, a herbal remedy, attenuates adenosine monophosphate induced nasal responsiveness in seasonal allergic rhinitis

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Abstract
Background Butterbur (BB) or Petasites hybridus, a herbal remedy, exhibits in vitro inhibition of cysteinyl leukotriene biosynthesis. However, no placebo‐controlled studies have been performed to evaluate the effectiveness of BB on objective outcomes such as nasal provocation testing in seasonal allergic rhinitis (SAR). Methods Twenty patients with grass‐pollen‐sensitized SAR were randomized in a double‐blind, cross‐over manner to receive for 2 weeks either BB 50 mg twice daily or placebo (PL) twice daily during the grass pollen season. Nasal adenosine monophosphate (AMP) challenge (the primary outcome) was administered as a single 400 mg/mL dose after each randomized treatment. Results Spontaneous recovery following AMP challenge (area under the response time profile curve as %.min±SEM) was significantly attenuated (P=0.028) with BB (584±289) compared to PL (1438±240); mean difference: 854 (95% CI 95–1614), and the maximum % peak nasal inspiratory flow reduction from baseline following AMP challenge was significantly blunted (P=0.036) with BB (30±4) compared to PL (43±5); mean difference: 13 (95% CI 1–25). Conclusions BB exhibited protection against AMP‐induced nasal responsiveness during the grass pollen season in sensitized patients. This is turn may explain its potential clinical efficacy in patients with SAR.

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