{"title":"Adverse effects of herbal preparations of Pistacia species: a systematic review and meta-analysis of randomised controlled clinical trials","authors":"Saeid Mohseni , Narjes Gorji , Reihaneh Moeini , Zahra Meamariani , Hoda Shirafkan","doi":"10.1016/j.hermed.2024.100988","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div><em>Pistacia</em> species (spp.) have nutritional and therapeutic usage. This systematic review and meta-analysis aimed to assess the safety of herbal preparations of <em>Pistacia</em> spp. in the randomised controlled clinical trials.</div></div><div><h3>Methods</h3><div>Relevant keywords were searched in PubMed, Embase, Scopus, Web of Science, and Google Scholar up to August 2023. The quality and risk of bias were assessed using the Cochrane Collaboration tool. Pooled effect sizes for adverse events and withdrawal rates were reported as relative risks (RR) and 95% confidence intervals (CI) using RevMan software. Forest plots were generated to visualise effect sizes for each comparison.</div></div><div><h3>Results</h3><div>Twenty-six eligible randomised controlled clinical trials (RCTs) were included in the pooled analysis (1<!--> <!-->851 subjects). Finally, 14 and 13 adverse events were reported for the intervention and comparator groups, respectively, without any significant difference (RR: 0.99 [95% CI: 0.48, 2.05]; Z: 0.01, <em>P</em>: 0.99). Most adverse events in the experimental groups were mild gastrointestinal events. The intervention groups reported lower withdrawal rate than the comparator groups. However, the difference was not significant (RR: 0.81 [95% CI: 0.62, 1.05]; Z: 1.61, <em>P</em>: 0.11). These findings were consistent across <em>Pistacia</em> spp. and treatment indication subgroups.</div></div><div><h3>Conclusion</h3><div>The safety of <em>Pistacia</em> spp. was comparable to that of placebo, regular diet, or conventional treatments, with few adverse events and no serious adverse events. However, given the high risk of bias, such as small sample sizes, future high-quality, large-scale RCTs with diverse demographics are necessary to confirm the safety and efficacy of these preparations especially for specific populations or long-term usage.</div></div>","PeriodicalId":56077,"journal":{"name":"Journal of Herbal Medicine","volume":"49 ","pages":"Article 100988"},"PeriodicalIF":2.2000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Herbal Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2210803324001453","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Pistacia species (spp.) have nutritional and therapeutic usage. This systematic review and meta-analysis aimed to assess the safety of herbal preparations of Pistacia spp. in the randomised controlled clinical trials.
Methods
Relevant keywords were searched in PubMed, Embase, Scopus, Web of Science, and Google Scholar up to August 2023. The quality and risk of bias were assessed using the Cochrane Collaboration tool. Pooled effect sizes for adverse events and withdrawal rates were reported as relative risks (RR) and 95% confidence intervals (CI) using RevMan software. Forest plots were generated to visualise effect sizes for each comparison.
Results
Twenty-six eligible randomised controlled clinical trials (RCTs) were included in the pooled analysis (1 851 subjects). Finally, 14 and 13 adverse events were reported for the intervention and comparator groups, respectively, without any significant difference (RR: 0.99 [95% CI: 0.48, 2.05]; Z: 0.01, P: 0.99). Most adverse events in the experimental groups were mild gastrointestinal events. The intervention groups reported lower withdrawal rate than the comparator groups. However, the difference was not significant (RR: 0.81 [95% CI: 0.62, 1.05]; Z: 1.61, P: 0.11). These findings were consistent across Pistacia spp. and treatment indication subgroups.
Conclusion
The safety of Pistacia spp. was comparable to that of placebo, regular diet, or conventional treatments, with few adverse events and no serious adverse events. However, given the high risk of bias, such as small sample sizes, future high-quality, large-scale RCTs with diverse demographics are necessary to confirm the safety and efficacy of these preparations especially for specific populations or long-term usage.
期刊介绍:
The Journal of Herbal Medicine, the official journal of the National Institute of Medical Herbalists, is a peer reviewed journal which aims to serve its readers as an authoritative resource on the profession and practice of herbal medicine. The content areas of the journal reflect the interests of Medical Herbalists and other health professionals interested in the clinical and professional application of botanical medicines. The objective is to strengthen the research and educational base of herbal medicine with research papers in the form of case studies, original research articles and reviews, monographs, clinical trials and relevant in vitro studies. It also publishes policy statements, opinion pieces, book reviews, conference proceedings and profession related information such as pharmacovigilance reports providing an information source for not only the Herbal Practitioner but any Health professional with an interest in phytotherapy.