Anemia Clinical Trial
Official title:
A Prospective Phase II/III Randomized, Blinded Study to Demonstrate the Safety and Effectiveness of Jobelyn ( a Herbal Preparation ) in Pre-operative Management of Anaemia in Gynaecological Patients
PROTOCOL FOR THE STUDY OF THE SAFETY AND EFFICACY OF JOBELYN, IN THE PREOPERATIVE MANAGEMENT OF ANAEMIA IN GYNAECOLOGICAL PATIENTS
It has long been known that anaemia increases the risk of death and complications in
patients who have cardiovascular surgery, but results of a recent study show that these
risks are increased in patients with anaemia who undergo various types of surgery, including
gynaecological procedures.
Compared with patients without anaemia, the risk of death within 30 days after surgery was
42% higher among patients with anaemia. In addition, patients with anemia were 35% more
likely to experience cardiac, respiratory, urinary, and wound complications as well as
sepsis and blood clots.
Because even mild anaemia increases the risk of postoperative morbidity in patients
undergoing major non-cardiac surgery, doctors need to consider preoperative treatment of
anaemia when possible. More research is needed to establish the efficacy, safety and
cost-effectiveness of pre-operative anaemia management.
One of the major clinical issues in many gynaecological patients in Nigeria is that of
optimizing the packed cell volume before surgery. Anaemia could be traced to multiple
factors notable of which are high prevalence of infection, worm infestation and malnutrition
(R). In other to reduce the waiting time and reduce morbidity and mortality associated with
surgery, it is important to correct the packed cell volume adequately before surgery.
The traditional method of correcting PCV involves the use of 'routine' haematinics such as
Ferrous sulphate, Folic acid and Multivitamin. This is in addition to dietary advice. While
the efficacy of these drugs has been well acknowledged in clinical practice, there is dearth
of literatures on their specific influence on haematological parameters. Majority of
Nigerians are gradually having a change of perception about traditional medicines with
gradual shift towards their use. It is believed that traditional drugs act faster and more
effective than other orthodox drugs in conventional use. One of such area is in the
correction of anaemia.
Sorghum bicolor, a grain long used in Africa for its high nutritional value also exhibits
strong antioxidant properties and antiinflammatory effects. The traditional preparation of
Sorghum bicolor has an oxygen radical absorbance capacity (ORAC) OF 37,622 micro mole TE/g.
This is much higher than other botanical preparations. Complementing the antioxidant
properties, Sorghum bicolor also exhibits anti inflammatory effects and demonstrated
selective COX-2 inhibition, providing effective reduction in inflammation without residual
side effects.
Sorghum bicolor extract has been shown to increase the haematocrit and haemoglobin level and
reduce the white cell count in trypanosome brucei brucei induced anaemia in experimental
rabbits. These effects were conclusive within 49 days of experimentation. Animals sacrificed
after the administration of lethal dose Jobelyn were shown to have congestion of the liver,
kidneys and lungs. This might be as a result of direct effect on these organs or a sign of
cardiotoxicity. However there is a wide therapeutic range.
Sorghum bicolor is the proprietary name for the product intended to treat sickle cell
disease. It is exactly the same as jobelyn which is currently marketed as a nutritional
supplement. Jobelyn is marketed in 250mg capsules of sorghum bicolor leaf extract. The
product is widely marketed in the United States and in Nigeria. Many pregnant women have
been using it regularly for a long time without any report of adverse effect.
The sorghum bicolor extract is expected to increase the haematocrit of' pregnant women
within a short time.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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