Treating intermittent allergic rhinitis: a prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze 339


  • Participating Clinics (alphabetical order): Dr J. P. Engel (Ingolstadt); Dr J. Horn (Butzbach); Dr W. D. Kaiser (Erfurt); Dr M. Kortüm (Schrecksbach); Dr R. Martin (Bad Soden); Dr A. Massing (Offenbach); Dr U. Nemec-Held (Oberursel); Dr S. Sauer (Hüttenberg); Dr A. Schapowal (Landquart); Dr R. Schellenberg (Hüttenberg); Dr M. Simonsohn (Frankfurt).


Background: Intermittent allergic rhinitis (IAR) causes patients distress and impairs their work performance and quality of life. A variety of medicines are used by sufferers whose anguish frequently leads to trying new treatments, increasingly from herbal sources.

Methods: Prospective, randomized, double-blind, parallel group comparison study of Butterbur extract (Ze 339; 8 mg total petasine; one tablet thrice-daily), fexofenadine (Telfast 180®, one tablet once-daily) and placebo in 330 patients. Protocol and analysis were according to the latest guidelines on new treatments for allergic rhinitis. The primary efficacy variable was a change in symptoms from baseline to endpoint during daytime. The secondary efficacy variables were: (a) as per primary variable (evening/night); (b) Physician's global assessment; (c) Responder rates. Safety was closely monitored.

Findings: Both active treatments were individually significantly superior to placebo (p < 0.001) in improving symptoms of IAR, while there were no differences between the two active treatments (p = 0.37). Superiority to placebo was similarly shown during the evening/night (p < 0.001), by physicians' own assessment and by responder rates. Both treatments were well tolerated.

Interpretation: Butterbur Ze 339 and Fexofenadine are comparably efficacious relative to placebo. Despite being a herbal drug, Butterbur Ze 339 has now been subject to a series of well controlled trials and should be considered as an alternative treatment for IAR. Copyright © 2005 John Wiley & Sons, Ltd.