Gevalin™ Aegle marmelos fruit extract improves gastrointestinal symptoms, quality of life and inflammatory markers in symptomatic adults: a randomized, double-blind and placebo-controlled trial
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20263697Keywords:
Aegle marmelos, Bael, Nutraceutical, Gut health, Inflammatory biomarkersAbstract
Background: This is randomised, double-blind, placebo-controlled trial evaluated the efficacy and tolerability of Gevalin™, a standardised Aegle marmelos (bael) fruit extract, in adults with chronic upper gastrointestinal symptoms such as postprandial fullness, early satiation, bloating, acidity, and epigastric discomfort etc.
Methods: Eighty-four adults meeting Rome IV criteria were randomised 1:1 to Gevalin™ 250 mg (n=42) or placebo (n=42) once daily for 56 days. The primary endpoint was change in GIS Rating Scale (GSRS) total score from baseline to Day 56. Secondary outcomes were gastrointestinal symptom and Functional Dyspepsia Related Quality of Life (FDQoL) total scores; inflammatory and oxidative stress biomarkers were exploratory. Analysis was per protocol (n=40 vs. 38).
Results: Gevalin™ significantly reduced GSRS total score versus placebo (change -3.87±4.03 vs. -0.55±1.19; difference -3.32, 95% CI -4.66 to -1.98; p<0.0001), a 20.2% vs. 2.7% reduction. Gastrointestinal symptom total score improved significantly (-7.30±5.25 vs. +0.29±2.73; p<0.0001), as did all four FDQoL domains (p≤0.0083). Exploratory analyses showed greater reductions in erythrocyte sedimentation rate (p<0.0001), C-reactive protein (p=0.0119), and 8-hydroxy-2′-deoxyguanosine (p=0.0076), and improved sleep quality (p<0.0001). No serious or treatment-related adverse events (AEs) were reported.
Conclusions: Gevalin™ significantly improved GISs, quality of life, sleep quality, and selected exploratory biomarkers over 56 days, with favorable short-term tolerability, and warrants confirmation in multicentre trials with long-term follow-up.
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References
Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Stanghellini V, et al. Worldwide prevalence and burden of functional gastrointestinal disorders. Gastroenterology. 2021;160:99-114. DOI: https://doi.org/10.1053/j.gastro.2020.04.014
Lee K, Kwon CI, Yeniova AÖ, Koyanagi A, Jacob L, Smith L, et al. Global prevalence of functional dyspepsia according to Rome criteria, 1990-2020: a systematic review and meta-analysis. Sci Rep. 2024;14(1):4172. DOI: https://doi.org/10.1038/s41598-024-54716-3
Ford AC, Marwaha A, Sood R, Moayyedi P. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis. Gut. 2015;64(7):1049-57. DOI: https://doi.org/10.1136/gutjnl-2014-307843
Drossman DA, Hasler WL. Rome IV-Functional GI disorders: disorders of gut–brain interaction. Gastroenterology. 2016;150(6):1257-61. DOI: https://doi.org/10.1053/j.gastro.2016.03.035
Ford AC, Lacy BE, Talley NJ. Functional dyspepsia. Lancet. 2020;396(10263):1689-702. DOI: https://doi.org/10.1016/S0140-6736(20)30469-4
Tack J, Talley NJ, Holtmann G, Stanghellini V, Miwa H, Vakil N. Pathophysiology and treatment of functional dyspepsia. Gastroenterology. 2021;160:1060-79.
Mayer EA, Nance K, Chen S. The gut microbiome and functional gastrointestinal disorders. Gut. 2018;67(3):1594-601.
Moayyedi P, Soo S, Deeks J. The efficacy of proton pump inhibitors in nonulcer dyspepsia. Gastroenterology. 2004;127(5):1329-37. DOI: https://doi.org/10.1053/j.gastro.2004.08.026
Asghari M, Ahmadpour S, Molazadeh M, Jafari MM, Hormati A, Pashaei MR, et al. Comparison of the effects of Govarcin herbal capsule and metoclopramide for alleviating gastrointestinal symptoms in patients with functional dyspepsia: a randomized double-blind clinical trial. Rev Recent Clin Trials. 2024;19(2):143-9. DOI: https://doi.org/10.2174/0115748871266848231120112355
Ayurvedic Pharmacopoeia of India. Part I, Vol. I. New Delhi: Ministry of Health and Family Welfare, Government of India. 2001.
AYUSH National Formulary of Ayurvedic Medicine. 2nd ed. New Delhi: AYUSH. 2011.
Baliga MS, Bhat HP, Joseph N, Fazal R. Phytochemistry and medicinal uses of the bael fruit (Aegle marmelos Correa): a concise review. Food Res Int. 2011;44(7):1768-75. DOI: https://doi.org/10.1016/j.foodres.2011.02.008
Sarkar T, Pati S, Patra GK, Raychaudhuri S. In-depth pharmacological and nutritional properties of bael (Aegle marmelos): a critical review. J Agric Food Res. 2020;2:100081. DOI: https://doi.org/10.1016/j.jafr.2020.100081
Brijesh S, Tejashree P. Studies on the antidiarrhoeal activity of Aegle marmelos unripe fruit: validating its traditional usage. BMC Complement Altern Med. 2009;9:47. DOI: https://doi.org/10.1186/1472-6882-9-47
Rathee JS, Zarma Q, Sharma AK, Kumar A, Singh M. Gastroprotective effect of Aegle marmelos: preclinical observations. J Ethnopharmacol. 2009;121(4):243-7.
Arul V, Miyazaki S, Dhananjayan R. Anti-inflammatory activity of Aegle marmelos. Indian J Exp Biol. 2004;42(1):396-9.
Sabu MC, Kuttan R. Antioxidant activity and cytotoxicity of Aegle marmelos (L.) Corr. ex Roxb. (Rutaceae). J Clin Biochem Nutr. 2004;34:11-9.
Choghakhori R, Abbasnezhad A, Amani D, Alipour M. Inflammatory cytokines and oxidative stress biomarkers in irritable bowel syndrome: association with digestive symptoms and quality of life. Cytokine. 2017;93:34-43. DOI: https://doi.org/10.1016/j.cyto.2017.05.005
Camilleri M. Peripheral mechanisms in irritable bowel syndrome. N Engl J Med. 2012;367:1626-35. DOI: https://doi.org/10.1056/NEJMra1207068
Svedlund J, Sjodin AL, Dotevall G. GSRS-a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig Dis Sci. 1988;33:129-34. DOI: https://doi.org/10.1007/BF01535722
Dimenäs E, Glise H, Hallerbäck B, Hernqvist H, Hultén S, Olofsson S, et al. Quality of life in patients with upper gastrointestinal symptoms: an improved evaluation of treatment regimens? Scand J Gastroenterol. 1993;28:681-7. DOI: https://doi.org/10.3109/00365529309098272
Chassany O, Marquis P, Schorr B, Mueller P, Simon T, Modiano P, et al. Validation of a specific quality of life questionnaire for functional digestive disorders. Gut. 1999;44:527-33. DOI: https://doi.org/10.1136/gut.44.4.527
Holtmann G, Adam B, Haag S, Collet W, Grünewald E, Windeck T. Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six-week placebo-controlled, double-blind, multicentre trial. Aliment Pharmacol Ther. 2003;18(11-12):1099-105. DOI: https://doi.org/10.1046/j.1365-2036.2003.01767.x
May B, Kuntz HD, Kieser M, Köhler S. Efficacy of a fixed peppermint oil/caraway oil combination in non-ulcer dyspepsia. Arzneimittelforschung. 1996;46(12):1149-53.
May B, Köhler S, Schneider B. Efficacy and tolerability of a fixed combination of peppermint oil and caraway oil in patients suffering from functional dyspepsia. Aliment Pharmacol Ther. 2000;14(12):1671-7. DOI: https://doi.org/10.1046/j.1365-2036.2000.00873.x
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