Echinacea has a long history of traditional use in North America for upper respiratory tract infections (URTIs).
A recent study has shown that formulae containing Echinacea purpurea may be as effective as Oseltamivir, an antiviral medication used to treat and prevent influenza A and influenza B, in the early treatment of clinically diagnosed influenza virus.
The randomised, double-blind, parallel, double dummy controlled multicenter clinical trial included 464 adults aged 18-70 years and nine children and adolescents aged 12-17 years with early acute influenza symptoms. Diagnosis was confirmed on the basis of: at least one respiratory symptom (sore throat, cough, nasal symptoms); at least one systemic symptom (headache, sweats and/or chills, fatigue, malaise, myalgia); and nasal swab testing for viral identification. Exclusion criteria included influenza vaccination within the previous 12 months, suspected bacterial infection, bronchitis, use of steroid or immune-suppressive medication and intake of antimicrobial agents within the previous month.
Participants were randomised to receive either 5mL of a syrup containing 1200mg echinacea (both herb extract and root extract) and 1382.5mg Sambuccus nigra and Oseltamivir placebo (n = 237) for 10 days (5mL five times a day for three days, followed by 5mL three times a day for seven days) or syrup placebo and two capsules of Oseltamivir (n = 236) for 5 days, followed by syrup placebo and Oseltamivir placebo for 5 days. Participants recorded influenza symptoms in the morning and evening for the duration of the study or until recovery.
Recovery rates were similar across both groups at 1.5% and 4.1% after one day, 50.2% and 48.8% after five days and 90.1% and 84.4% after 10 days of treatment with the syrup and Oseltamivir, respectively. In addition, the echinacea syrup treatment group saw a significantly lower incidence of complications (2.46% vs 6.45%; p = 0.076) and fewer adverse events. This research builds on current knowledge of the immunomodulatory effects of echinacea, as well as confirming similar effects seen in vitro and in animal models.[5,6]
Considering the risk of drug resistance, safety issues and limited availability associated with neuraminidase inhibitors like Oseltamivir, echinacea may be a more convenient option for early influenza therapy.
- Morazzoni P, Cristoni A, Di Pierro F, et al. In vitro and in vivo immune stimulating effects of a new standardized Echinacea angustifolia root extract (PolinaceaTM). Fitoterapia 2005;76:401-411. [Abstract]
- Rauš K, Pleschka S, Klein P, et al. Effect of an echinacea-based hot drink versus Oseltamivir in influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. Curr Ther Res Clin Exp 2015;77:66-72. [Full text]
- Dall’Acqua S, Perissutti B, Grabnar I, et al. Pharmacokinetics and immunomodulatory effect of lipophilic echinacea extract formulated in softgel capsules. Eur J Pharm Biopharm 2015;97(Pt A):8-14. [Abstract]
- Pleschka S, Stein M, Schoop R, et al. Anti-viral properties and mode of action of standardized Echinacea purpurea extract against highly pathogenic avian influenza virus (H5N1, H7N7) and swine-origin H1N1 (S-OIV). Virol J 2009;6:197. [Full text]
- Bałan BJ, Sokolnicka I, Skopińska-Różewska E, et al. The modulatory influence of some echinacea-based remedies on antibody production and cellular immunity in mice. Cent Eur J Immunol 2016;41(1):12-18. [Full text]
- Fusco D, Liu X, Savage C, et al. Echinacea purpurea aerial extract alters course of influenza infection in mice. Vaccine 2010;28(23):3956-3962. [Full text]