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DOI: 10.1055/s-0035-1569406
The Safety and Tolerability of Lumbrokinase DLBS1033 in Healthy Adult Subjects
Publication History
received 04 September 2015
accepted 04 January 2016
Publication Date:
24 March 2016 (online)
Abstract
Background: This study was aimed to evaluate the safety and tolerability of Lumbrokinase DLBS1033 in healthy adult subjects.
Methods: This was a 2-arm, randomized, double-blind, placebo-controlled, cross-over study over 14 days of treatment with DLBS1033 490 mg 3 times daily. Eligible subjects were enrolled at Period 1 and allocated to receive either test drug or placebo, and underwent a clinical assessment including vital signs, electrocardiography, laboratory examination (hemostasis parameters, routine hematology, liver and renal function), the presence of hemorrhagic symptoms and allergic reactions. Afterwards, they went on to a 2-week washout period, and then were crossed-over to receive the alternate drug at Period 2. The procedure of Period 1 was repeated in the same manner with the alternate drug at Period 2.
Results: Of 20 subjects enrolled, one subject was lost to follow-up on Evaluation Day-14 of Period 2. Bleeding risk was relatively low as demonstrated by insignificant differences in hemostasis parameters between DLBS1033 and Placebo. Neither were there significant differences between DLBS1033 and Placebo in terms of hematological parameter, each blood chemistry parameter (liver function, renal function, lipid profile, fasting blood glucose), abnormality proportions of urine test, stool occult blood, and ECG interpretation. There were no hemorrhagic symptoms (petechiae, epistaxis, hematoma) and allergic reactions encountered by study subjects during the treatment with DLBS1033 and Placebo.
Major Conclusion: DLBS1033 given at the dose of 490 mg 3 times daily was safe and tolerable in healthy adults.
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References
- 1 Willem V, Minne A. Recherches sur la digestion et l’absorption intestinale chez le lombric. In: Livre Jubilaire Dédié à Charles van Bambeke, Henri Lamertin, Bruxelles 1899; pp 201-222
- 2 Mihara H, Sumi H, Yoneta T et al. A novel fibrinolytic enzyme extracted from the earthworm, Lumbricus rubellus. Jpn J Physiol 1991; 41: 461-472
- 3 Kasim M, Kiat AA, Rohman MS et al. Improved myocardial perfusion in stable angina pectoris by oral lumbrokinase: A pilot study. J Altern Complem Med 2009; 15: 539-544
- 4 Gao Y, Qin MZ. Lumbrokinase in treatment of patients with hyperfibrinogenemia of coronary atherogenesis disease. J Cap Univ Med Sci 1999; 20: 264-265
- 5 Jin LR, Jin H, Zhang G et al. Changes in coagulation and tissue plasminogen activator after the treatment of cerebral infarction with lumbrokinase. Clin Hemorheol Micro 2000; 23: 213-218
- 6 Jin LR, Wang X, Fan W. A Prospective random double-blinded study on the changes of coagulation-fibrinolysis system in poststroke patients receiving treatment of lumbrokinase. J Chin Microcirc 2001; 3: 7-11
- 7 Trisina J, Sunardi F, Suhartono MT et al. DLBS1033, a protein extract from Lumbricus rubellus, possesses antithrombotic and thrombolytic activities. J Biomed & Biotech 2011; Article ID 519652: 1–7
- 8 Nakajima M, Mihara H, Sumi H. Characterization of potent fibrinolytic enzymes in earthworm, Lumbricus rubellus. Biosci Biotech Biochem 1993; 57: 1726-1730
- 9 Cho IH, Choi ES, Lim HG et al. Purification and characterization of six fibrinolytic serine-proteases from earthworm Lumbricus rubellus. J Biochem Mol Biol 2004; 37: 199-205
- 10 Zhao YG, Li H, Xu W et al. An Overview of the fibrinolytic enzyme from earthworm. Chin J Nat Med 2010; 8: 301-308
- 11 Sajuthi D, Suhartono MT, Tjandrawinata RR. Safety study of DLBS1033 bioactive protein fractions in long-tailed macaques (Macaca fascicularis). [Bahasa]. Medicinus 2011; 24: 15-21
- 12 Sukandar EY, Anggadireja K, Sigit JI et al. Toxicity studies of a bioactive protein with antithrombotic-thrombolytic activity, DLBS1033. Drug Chem Toxicol 2014; 37: 8-16
- 13 World Medical Association Declaration of Helsinki. Ethical Principles for Medical Research Involving Human Subjects. Adopted by the 18th WMA General Assembly, Helsinki, Finland, June 1964, and last amended by the 64th WMA General Assembly, Fortaleza, Brazil, October 2013. Available from: http://www.wma.net/en/30publications/10policies/b3/ Accessed August 21, 2015
- 14 International Conference on Harmonisation (ICH) Topic E6. Harmonised Tripartite Guideline for Good Clinical Practice. Step 5, Consolidated Guideline 1 May 1996. Available from: http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Efficacy/E6/E6_R1_Guideline.pdf Accessed August 21, 2015
- 15 Badan Pengawas Obat dan Makanan Republik Indonesia (BPOM RI). Pedoman Cara Uji Klinik yang Baik. BPOM RI Guideline for Good Clinical Practice. [Bahasa]. Jakarta: 2001
- 16 Badan Pengawas Obat dan Makanan Republik Indonesia (BPOM RI). Peraturan Kepala Badan Pengawas Obat dan Makanan Republik Indonesia Nomor 13 Tahun 2014 tentang Pedoman Uji Klinik Obat Herbal. BPOM RI Guideline for Clinical Trials on Herbal Medicines. [Bahasa]. Jakarta: 2014
- 17 Tjandrawinata RR, Trisina J, Rahayu P et al. Bioactive protein fraction DLBS1033 containing lumbrokinase isolated from Lumbricus rubellus: ex vivo, in vivo, and pharmaceutic studies. Drug Des Devel Ther 2014; 8: 1585-1593
- 18 Sarver JD, White D, Erhardt P et al. Estimating xenobiotic half-lives in humans from rat data: influence of log P. Environ Health Perspect 1997; 105: 1204-1209
- 19 Caso G, Mileva I, Kelly P et al. Feeding acutely stimulates fibrinogen synthesis in healthy young and elderly adults. J Nutr 2009; 139: 2032-2036
- 20 Hunter K, Garlick P, Broom I et al. Effects of smoking and abstention from smoking on fibrinogen synthesis in humans. Clin Sci 2001; 100: 459-465
- 21 Ercan M, Yeğin E, Akdeniz H et al. Effect of estrogen on fibrinogen clotting time in rabbits. J Vet Animal Sci 1998; 22: 137-140
- 22 Kadir RA, Economides DL, Sabin CA et al. Variations in coagulation factors in woman: effects of age, ethnicity, menstrual cycle, and combined oral contraceptive. Thromb Haemostasis 1999; 82: 1456-1461
- 23 Verma MK, Pulicherla KK. Lumbrokinase – A potent and stable fibrin–specific plasminogen activator. International Journal of Bio-Science and Bio-Technology 2011; 3: 57-70
- 24 Grossfeld GD, Litwin MS, Wolf JS et al. Evaluation of asymptomatic microscopic hematuria in adults: the American Urological Association best practice policy – part I: definition, detection, prevalence, and etiology. Urology 2001; 57: 599-603
- 25 Winawer SJ. Fecal occult blood testing. Am J Dig Dis 1976; 21: 885-888