Independent Studies Proving Once Again that EPO Significantly Improves Symptoms of Atopic Eczema 1.

The latest multi-centered, open clinical trial of EPO for the treatment of atopic eczema/dermatitis (AD) has confirmed findings of Efamol scientists nearly 3 decade earlier – EPO is an effective treatment for this debilitating skin condition. The collaboration among the University Hospital of Bern, Children’s Hospitals Aarau, Children’s Hospitals Lucerne, Pediatric Practice at Rigiplatz, MaxZeller Söhne, Brunner & Hess Software AG, University Hospital of Zurich and Hospital Zollikerberg, Switzerland, included 21 patients between 3-58 years with AD supplemented with 4-6 capsules of EPOGAM (previously the prescription drug format of Efamol EPO) containing 80 mg of GLA per 1000 mg capsule daily for 12 weeks. Before and after 4 and 12 weeks of treatment, each patient supplied a blood sample to determine their gamma-linolenic acid (GLA) and dihommogammalinolenic acid (DGLA) status.  These two fatty acids are lower than normal is many people with AD and EPO treatment can increase the concentration of these two fatty acids to normal. In addition, the AD scoring index (SCORAD) was used to measure symptoms of AD at baseline and 4 and 12 weeks following treatment including redness, swelling, itching, weeping/crusting, excoriation, lichenification, dryness and total intensity.

The results showed that EPO improves symptoms of atopic eczema while increasing blood levels of GLA and DGLA.  At baseline, 42.9% of the patients had mild symptoms and 57.1 % had moderate symptoms. After 12 weeks treatment, 93.2% of the patients had mild symptoms, whereas only 6.8% had moderate symptoms. The clinical improvements in disease activity under EPO treatment correlated with individual increases in plasma GLA levels indicating that GLA may be responsible for the improvement and that GLA could be used as a marker to identify responders.  Thus, patients without an increase in plasma GLA after 4 weeks would be regarded as non-responders and could be recommended to stop therapy while those that did have increased GLA levels could proceed and expect to achieve successful treatment.

A study last year reported similar results where symptoms including redness, skin thickness, itching and lichenification improved significantly and in a dose dependent manner following supplementation with eight 500 mg capsules of EPO for 8 weeks2. In addition, there was a dose dependent improvement in symptoms and in the concentration of serum GLA and AA (arachidonic acid), showing that EPO supplementation was responsible for the benefits. That randomised, parallel trial included 40 children and adolescents aged between 2 and 15 years having had eczema for about 8.6 months. There were no side effects associated with EPO treatment.

Atopic eczema is a skin condition affecting up to 30% of children in Westernized countries3, up to 10% of adults1 and is a non-infectious, chronically relapsing inflammatory condition causing scaliness, dryness, redness, cracks, sores and severe itching, which from the patient’s perspective is the most troublesome symptom. It starts in infancy or early childhood, continues throughout life and runs in families. An associated abnormality in fatty acid metabolism was first proposed in the early 1930s and a study at the Efamol Research Institute in the early 1980s confirmed that people with atopic eczema had lower than normal blood levels of linoleic acid (LA) metabolites including GLA and other fatty acids derived from it including DGLA and AA4,5. 

In 2008, a group of researchers in Taipei looked at the relationship between omega-6 fatty acid deficiency, water loss through the skin (TEWL) and immune response in children with atopic disorders6.  The study included 35 children with atopic eczema, 35 age matched children with allergic rhinitis, asthma or both and 31 nonatopic controls.  Results showed that atopic children had higher levels of LA and lower levels of its metabolites including GLA, DGLA and AA. Furthermore, it showed that the more deficient they were in GLA, DGLA and AA, the more severe was their atopic dermatitis and the greater was the loss of water through their skin.  Those with the highest LA had the worst TEWL and atopic eczema.

Dietary GLA supplementation can partially correct the deficiency of GLA, DGLA and AA in people with atopic eczema4.  A study in India reported a 96% response rate using EPO as a source of GLA to treat atopic eczema in an East Indian population7.  Results of this study also agree with those of two meta-analyses using Efamol EPO as the active reported in 1989 and 2007.  The 1989 investigation including 10 clinical studies showed that EPO was particularly effective for relieving itch and those patients who had the greatest increase in their blood levels of GLA, DGLA and AA also had the greatest improvement in their skin condition8.  The 2007 meta-analysis including 26 studies with more than 1200 patients confirmed that Efamol EPO is a safe and effective remedy for symptomatic relief of atopic eczema with simultaneous benefits on itch, crusting, swelling and redness that become apparent between 4 and 8 weeks after treatment is initiated9. 

Results of this latest independent study reflect those of the previously mentioned studies which further substantiates the use of GLA supplementation for skin health and in particular for the treatment of atopic eczema. In addition, it helps to explain why some people in previous studies have not achieved improvements following EP0 supplementation.

References:

1.             Simon D, Eng PA, Borelli S, Kägi R, Zimmermann C, Zahner C, Drewe J, Hess     L, Ferrari G, Lautenschlager S, Wüthrich B, Schmid-Grendelmeier P. Gamma-Linolenic Acid Levels Correlate with Clinical Efficacy of Evening Primrose Oil in Patients with Atopic Dermatitis. Adv Ther. 2014 Jan 17. [Epub ahead of print]

2.             Chung BY, Kim JH, Cho SI, Ahn IS, Kim HO, Park CW. Dose-dependent effects of evening primrose oil in                 children and adolescents with atopic dermatitis. Ann Dermatol 2013;25(3);285-291.

3.             http://www.medscape.com/viewarticle/586561

4.             Manku MS, Horrobin DF, Morse NL, Wright S, Burton JL.  Essential fatty acids in the plasma phospholipids               of patients with atopic eczema. British Journal of Dermatology. 1984:110:643-648.

5.             Manku MS, Horrobin DF. Morse N. Kyte V. Jenkins K. et al. Reduced levels of prostaglandin precursors in the           blood of atopic patients: defective delta-6-desaturase function as a biochemical basis for atopy. Prostaglandins        Leuko. Med. 1982;9(6):615-628.

6.             Chiung HY, Yang-Shia D, Yao-Hsu Y, Li-Chieh W, Jyh-Hong L, Bor-Luen C. Linoleic acid metabolite levels              and transepidermal water loss in children with atopic dermatitis. Annals of Allergy, Asthma and Immunology.   2008;100(1):66-73.

7.             Senapati S, Banerjee S, Gangopadhyay DN. Evening primrose oil is effective in atopic dermatitis: A             randomized placebo-controlled trial. Indian J Dermatol Venereol Leprol 2008;74:447-52.

8.             Morse PF. Horrobin DF. Manku MS. Stewart J. Allen, R. et al. Br. J. Dermatol. Meta-analysis of placebo-     controlled studies of the efficacy of Epogam in the treatment of atopic eczema. Relationship between plasma                essential fatty acid changes and clinical response.1989; 121(1):75-90.

9.             Morse NL and Clough PM. A Meta-Analysis of Randomized, Placebo-Controlled Clinical Trials of Efamol®               Evening Primrose Oil in Eczema.  Where do we go from here in light of more recent discoveries?  Current                      Pharmaceutical Biotechnology. 2006:7(6):503-24.

View Summary here >>>

View the product information leaflet >>>

This research has been provided by Efamol www.efamol.com