Efficacy of Kan Jang® in Patients with Mild COVID-19: A Randomized, Quadruple-Blind, Placebo-Controlled Trial

{ 'DOI': '10.3390/ph16091196', 'ISSN': ['1424-8247'], 'URL': 'http://dx.doi.org/10.3390/ph16091196', 'abstract': '<jats:p>Background and aim. This study aimed to assess the efficacy of the treatment of Kan ' 'Jang®, a fixed combination of Andrographis paniculata (Burm. F.) Wall. ex. Nees and ' 'Eleutherococcus senticosus (Rupr. &amp; Maxim.) Maxim extracts in patients with mild symptoms ' 'of COVID-19. Methods. One hundred and forty patients received six capsules of Kan Jang® (n = ' '68, daily dose of andrographolides—90 mg) or placebo (n = 72) and supportive treatment ' '(paracetamol) for 14 consecutive days in a randomized, quadruple-blinded, placebo-controlled, ' 'two-parallel-group design. The efficacy outcomes were the rate of cases turning to severe, ' 'the detection rate of coronavirus SARS-CoV-2 over the time of treatment, the duration, and ' 'the severity of symptoms (sore throat, runny nose, cough, headache, fatigue, loss of smell, ' 'taste, pain in muscles) in the acute phase of the disease. Other efficacy measures included ' 'improving cognitive and physical performance, quality of life, and the levels of inflammatory ' 'blood markers—interleukin 6 (IL-6), C-reactive protein, and D-dimer. Results. Kan Jang® ' 'significantly (p &lt; 0.05) reduced the rate of cases turning to severe (5.36%) compared to ' 'the placebo (17.86%) and decreased the detection rate of SARS-CoV-2 virus over the time of ' 'the treatment. The statistical difference in the rates of patients with clinical ' 'deterioration in the Kan Jang treatment and placebo control groups was significant (p = ' '0.0176) both in the 112 patients in the included-per-protocol (IPP) analysis and in the 140 ' 'patients in the intended-to-treat (ITT) analysis (p = 0.0236); the absolute risk reduction in ' 'cases thanks to the Kan Jang treatment was 12.5%, and the number we needed to treat with Kan ' 'Jang was 8. The patient’s recovery time (number of sick days at the home/clinic) was shorter ' 'in the Kan Jang group compared with the placebo group. The rate of attenuation of ' 'inflammatory symptoms in the Kan Jang® group was significantly higher, decreasing the ' 'severity of cough, sore throat/pain, runny nose, and muscle soreness compared with the ' 'placebo group. Kan Jang® significantly decreased the Wisconsin Upper Respiratory Symptoms ' 'scores compared to the placebo in the sample size of 140 patients. However, the relief of ' 'fatigue and headache and the decrease in IL-6 in the blood were observed only in a subset of ' '86 patients infected during the second three waves of the pandemic. Kan Jang® significantly ' 'increased physical activity and workout; however, it did not affect cognitive functions ' '(attention and memory), quality of life score, inflammatory marker D-dimer, and C-reactive ' 'protein compared with the placebo group. Conclusions. Overall, the results of this study ' 'suggest that Kan Jang® is effective in treating mild and moderate COVID-19 irrespective of ' 'the SARS-CoV-2 variant of infection.</jats:p>', 'alternative-id': ['ph16091196'], 'author': [ { 'affiliation': [ { 'name': 'Department of Infectious Diseases, The First University Clinic, ' 'Tbilisi State Medical University, Gudamakari St., Tbilisi 0141, ' 'Georgia'}], 'family': 'Ratiani', 'given': 'Levan', 'sequence': 'first'}, { 'affiliation': [ { 'name': 'Department of Infectious Diseases, The First University Clinic, ' 'Tbilisi State Medical University, Gudamakari St., Tbilisi 0141, ' 'Georgia'}], 'family': 'Pachkoria', 'given': 'Elene', 'sequence': 'additional'}, { 'affiliation': [ { 'name': 'Department for History of Medicine and Bioethics, Faculty of ' 'Medicine, Tbilisi State Medical University, Vazha-Pshavela Ave. ' '33, Tbilisi 0162, Georgia'}], 'family': 'Mamageishvili', 'given': 'Nato', 'sequence': 'additional'}, { 'affiliation': [ { 'name': 'Department for History of Medicine and Bioethics, Faculty of ' 'Medicine, Tbilisi State Medical University, Vazha-Pshavela Ave. ' '33, Tbilisi 0162, Georgia'}], 'family': 'Shengelia', 'given': 'Ramaz', 'sequence': 'additional'}, { 'affiliation': [ { 'name': 'Institute of Fine Organic Chemistry of the National Academy of ' 'Science, Azatutian Ave. 26, Yerevan 375014, Armenia'}], 'family': 'Hovhannisyan', 'given': 'Areg', 'sequence': 'additional'}, { 'ORCID': 'http://orcid.org/0000-0002-8467-4525', 'affiliation': [ { 'name': 'Phytomed AB, Sjöstadsvägen 6A, Lgh 1004, 59344 Västervik , ' 'Sweden'}], 'authenticated-orcid': False, 'family': 'Panossian', 'given': 'Alexander', 'sequence': 'additional'}], 'container-title': 'Pharmaceuticals', 'container-title-short': 'Pharmaceuticals', 'content-domain': {'crossmark-restriction': False, 'domain': []}, 'created': {'date-parts': [[2023, 8, 22]], 'date-time': '2023-08-22T12:58:54Z', 'timestamp': 1692709134000}, 'deposited': { 'date-parts': [[2023, 8, 22]], 'date-time': '2023-08-22T13:54:45Z', 'timestamp': 1692712485000}, 'funder': [{'award': ['2021-1'], 'name': 'Swedish Herbal Institute AB in Vallberga, Sweden'}], 'indexed': {'date-parts': [[2023, 8, 23]], 'date-time': '2023-08-23T04:27:54Z', 'timestamp': 1692764874421}, 'is-referenced-by-count': 0, 'issue': '9', 'issued': {'date-parts': [[2023, 8, 22]]}, 'journal-issue': {'issue': '9', 'published-online': {'date-parts': [[2023, 9]]}}, 'language': 'en', 'license': [ { 'URL': 'https://creativecommons.org/licenses/by/4.0/', 'content-version': 'vor', 'delay-in-days': 0, 'start': { 'date-parts': [[2023, 8, 22]], 'date-time': '2023-08-22T00:00:00Z', 'timestamp': 1692662400000}}], 'link': [ { 'URL': 'https://www.mdpi.com/1424-8247/16/9/1196/pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '1968', 'original-title': [], 'page': '1196', 'prefix': '10.3390', 'published': {'date-parts': [[2023, 8, 22]]}, 'published-online': {'date-parts': [[2023, 8, 22]]}, 'publisher': 'MDPI AG', 'reference': [ { 'DOI': '10.1111/all.14364', 'article-title': 'Immune response to SARS-CoV-2 and mechanisms of immunopathological ' 'changes in COVID-19', 'author': 'Azkur', 'doi-asserted-by': 'crossref', 'first-page': '1564', 'journal-title': 'Allergy', 'key': 'ref_1', 'volume': '75', 'year': '2020'}, { 'DOI': '10.1038/s41577-020-0311-8', 'article-title': 'The trinity of COVID-19: Immunity, inflammation and intervention', 'author': 'Tay', 'doi-asserted-by': 'crossref', 'first-page': '363', 'journal-title': 'Nat. 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