Lack of effect of an Echinacea cocktail on exacerbations of COPD

Upper respiratory tract infections frequently exacerbate chronic-obstructive pulmonary disease (COPD).

Researchers in Indonesia and Switzerland evaluated the effect of Echinacea purpurea + micronutrients in order to reduce the severity of these infections.

First, the details.

  • 108 COPD adult patients with acute upper respiratory tract infections were randomly assigned to a treatment group treated with ciprofloxacin for 7 days plus 14 days of
    • 1 tablet per day of Echinacea purpurea
    • 1 tablet per day of Echinacea purpurea + zinc, selenium, and ascorbic acid
    • Placebo
  • Blood levels of TNFalpha (tumor necrosis factor alpha, which has a broad spectrum of biological effects) and interleukins 1beta, 6 and 10 (signaling molecules secreted by white blood cells) were measured before and after treatment.
  • All patients reported daily COPD symptoms until 4 weeks after treatment.
  • Neither the patients nor researchers knew the treatment given — double blind.

And, the results.

  • Echinacea + zinc, selenium, and ascorbic acid, but not Echinacea alone resulted in significantly less severe and shorter exacerbation episodes following URTI compared to placebo.
  • Changes in TNF and interleukins were unrelated to treatment.
  • Study medication was associated with 15 reports of side effects, 1 of which was serious.

The bottom line?

The authors concluded, “The combination of Echinacea purpurea, zinc, selenium, and vitamin C may alleviate exacerbation symptoms caused by upper respiratory tract infections in COPD.”

The authors believe there was a “synergistic effect of Echinacea on the micronutrients.” But there’s no evidence that Echinacea made any contribution to the clinical outcome associated with the cocktail. And there were no differences in TNF or the interleukins. So, where’s is the evidence supporting this conclusion?

Also, the authors fail (in the abstract) to define what constituted a “significant” effect on severity and duration of infection. We really don’t know if the “benefit” was a few hours, or a day. From a practical perspective, was it worth taking a handful of 4 supplements every day for 2 weeks?

11/12/10 20:50 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.