Chinese herbal medicine treatment based on subgroup differentiation as adjunct therapy for Parkinson’s disease: study protocol of a pilot add-on, randomised, controlled, pragmatic clinical trial

Sam Chun Sum Yuen, Ka Kit Chua, Linda L. D. Zhong, Kam Wa Chan, Conrad Kwan Ho Chan, Kam Leung Chan, Zhixiu Lin, Vincent Mok, Alexander Y. Lau*, Min Li*

*Corresponding author for this work

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Abstract

Background
Parkinson’s disease (PD) is a prevalent and debilitating condition. Conventional medications cannot control all symptoms and may inflict adverse effects. A survey reported that Chinese herbal medicine (CHM) is frequently sought. Existing CHM trials were contradictory and often of poor quality due to lack of methodological rigor. A national clinical guideline was drafted in China with diagnostic criteria and treatment strategy of Chinese medicine (CM) patterns subgroups of PD. The suggested CHM were found to exhibit neuroprotective effect in in vitro and in vivo studies. This trial aims to preliminarily assess the effect of CHM prescribed based on pattern differentiation on PD symptoms and patients’ quality of life, and evaluate the feasibility of the trial design for a future large-scale trial.

Methods
This trial will be a pilot assessor- and data analyst blind, add-on, randomised, controlled, pragmatic clinical trial. 160 PD patients will be recruited and randomised into treatment or control groups in a 1:1 ratio. The trial will be conducted over 32 weeks. PD patients in the treatment group will be stratified into subgroups based on CM pattern and receive CHM accordingly in addition to conventional medication (ConM). The control group will receive ConM only. The primary outcome will be part II of the Movement Disorder Society Sponsored Revision of Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Secondary outcomes will include part and total scores of MDS-UPDRS, domain and total scores of Non-motor symptom scale (NMSS). Adverse events will be monitored by monthly follow-ups and questionnaires. Mixed models will be used to analyse data by Jamovi and R.

Expected outcomes
The success of our trial will show that the pragmatic design with subgroup differentiation is feasible and can produce reliable results. It will also provide preliminary data of the effect of CHM on improving clinical outcomes and quality of PD patients. Data collected will be used to optimize study design of the future large-scale clinical study.


Original languageEnglish
Article number16
JournalChinese Medicine
Volume17
Issue number1
Early online date24 Jan 2022
DOIs
Publication statusE-pub ahead of print - 24 Jan 2022

Scopus Subject Areas

  • Complementary and alternative medicine
  • Pharmacology

User-Defined Keywords

  • Parkinson disease
  • Pragmatic Clinical Trial
  • Traditional Chinese medicine

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