Clinical evaluation of extract of Cajanus cajan (Ciklavit®) in sickle cell anaemia
Journal of Tropical Pediatrics
Department of Paediatrics, College of Medicine, University of Lagos, P.M.B. 12003, Lagos, Nigeria; Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, P.M.B. 12003, Lagos, Nigeria
The major pathology in sickle cell anaemia (SCA) is sickling of red cells due to the precipitation of reduced haemoglobin. We report our experience with extract of Cajanus cajan as a possible antisickling agent by determining changes, if any, in clinical and laboratory features of the disease in patients given the extract in a single-blind placebo-controlled study. One hundred patients with steady-state SCA were randomized into treatment and placebo arms. The extract/placebo were administered twice daily to the subjects. Weight, hepatosplenomegaly, blood levels of biliurubin, urea, creatinine, and packed cell volume (PCV) were monitored over a 6-month period. Recall episodes of pain 6 months before enrolment were compared with episodes of pains recorded during the treatment period. Twenty-six cases (55.3 per cent) had hepatomegaly on enrolment. This significantly reduced to 33.3 per cent at 6 months (p = 0.03); but increased in the placebo arm p = >0.05). The total number of recall painful episodes in cases was 207 (mean 4.4 ± 10.3 (SD), range 0-60) and fell to 191 (mean 4.2 ± 4.4 (SD), range 0-16); p = 0.03. Episodes of pain increased from 109 in controls (mean 2.6 ± 5.0 (SD), range 0-26) to 164 (mean 3.9 ± 4.3 (SD), range 0-22); p = 0.01. Mean PCV in the cases showed no appreciable changes p = 0.1) but there was a significant increase in the controls p = 0.02). In conclusion, the extract may cause a reduction of painful crises and may ameliorate the adverse effects of sickle cell anaemia on the liver. The mechanism of action remains to be determined. © The Author . Published by Oxford University Press. All rights reserved.
antisickling agent; ascorbic acid; bilirubin; Cajanus cajan extract; ciklavit; creatinine; folic acid; placebo; plant extract; proguanil; pyrimethamine; unclassified drug; urea; zinc; antisickling agent; plant medicinal product; abdominal distension; article; bilirubin blood level; body weight; child; clinical feature; clinical trial; controlled clinical trial; controlled study; creatinine blood level; diarrhea; fatigue; female; hematocrit; hepatomegaly; hepatosplenomegaly; human; liver disease; major clinical study; male; ocular pruritus; orbit inflammation; pain assessment; pigeonpea; randomized controlled trial; sickle cell anemia; sickle cell trait; single blind procedure; urea blood level; vomiting; adolescent; analysis of variance; drug effect; infant; liver; phytotherapy; pigeonpea; preschool child; Adolescent; Analysis of Variance; Anemia, Sickle Cell; Antisickling Agents; Cajanus; Child; Child, Preschool; Female; Humans; Infant; Liver; Male; Phytotherapy; Plant Preparations; Single-Blind Method