Wormwood for Poorly Responsive IgA Nephropathy
Sounds odd, but yes... wormwood may be helpful for patients suffering with IgA Nephropathy (IgAN).
Before we get to this study, you may be asking the same question I did initially.... What is "wormwood" ?
Apparently wormwood is a plant (shown here). For more information you can review Wikipedia like I did.
Back to IgAN... There is a general consensus and we typically use RAS (renin-angiotensin system) blockers now as first line therapy. But, unfortunately RAS blockers are not completely effective in most cases of clinically significant IgAN. There was some data on fish oil, but that remains controversial. Recent data has supported the role of TNF (tumor necrosis factor) in the pathogensis of IgAN. In vitro studies have shown that wormwood may decrease TNF levels. Therefore a study was designed to look at wormwood in patients with IgAN. The study was published in this month's American Journal of Kidney Diseases. This was a small pilot study of 10 patients with biopsy proven IgAN, normal kidney funtion and at least a 3 month history of proteinuria between 500-3500 mg /day despite RAS blockers.
The patients took 1.8 grams/ day of the wormwood preparation for 6 months while continuing on the RAS blockers. The results were spectacular with sharp reductions in proteinuria, stable renal function and even decreased mean arterial pressure.
* However, it should go without saying... but, I will say it anyway. This study is a PILOT. It is tiny (10 patients). It is short (6 months). It was not blinded. There was no control group. Creatinine clearance was preserved at baseline. Is the dose chosen for the wormwood prep the optimal dose? What are the long term effects of using wormwood?
Ultimately, wormwood (although fun to say), is not ready for primetime in the treatment of IgAN. But, I suspect there will be follow up studies to examine its possibly exciting potential.