Prostate news article, February 2006
| RANDOMIZED TRIAL OF SAW PALMETTO VERSUS
PLACEBO SUGGESTS NO BENEFIT Published in New England Journal of Medicine Reported by: Professor Roger S Kirby |
BERKELEY, CA (UroToday.com) - Saw palmetto is the dried fruit of the serona repens plant, a dwarf cactus that grows in the southwestern region of the United States. It is widely used as phytotherapy around the world. Saw palmetto is non-prescription and can be acquired in health food stores. A meta-analysis of several short, small studies have suggested that it is superior to placebo.
Dr. Bent and colleagues at the University of California, San Francisco
and its affiliated VA and Kaiser Permanente hospitals report a prospective,
randomized trial of saw palmetto vs. placebo in the February 9, 2006
issue of the New England Journal of Medicine.
Between 2001 and 2004, 225 men with moderate to severe symptoms of BPH
were randomized to placebo or 160mg of saw palmetto twice a day. Eligibility
criteria included an AUA symptom score >8 and a peak urinary flow
rate >15cc/sec. Participants had 8 follow-up visits over 12 months
with primary endpoints being symptom scores and flow rates. Secondary
endpoints included post-void residual urine, prostate volume, quality
of life and adverse events.
Men on saw palmetto did not have increased adverse events compared to placebo.
Saw palmetto did not result in improvements in any outcomes measured
compared to placebo.
A strength of this study is that the placebo group took an extract similar
to saw palmetto in consistency, appearance and taste. The results demonstrated
that blinding to treatment was effective, and this minimizes a decreased
response in the placebo arm. However, the mechanism of action of saw
palmetto is not known and whether appropriate levels of relevant compounds
were achieved cannot be verified. This of course, is a problem with herbal
therapy and a reality for those taking saw palmetto.