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Evidence-Based Supplement Research
Evidence-Based Supplement Research

Saw palmetto for benign prostatic hyperplasia.

  • 2006-02-09
  • The New England journal of medicine 354(6)
    • Stephen Bent
    • Christopher Kane
    • Katsuto Shinohara
    • John Neuhaus
    • Esther S Hudes
    • Harley Goldberg
    • Andrew L Avins

Study Design

Type
Randomized Controlled Trial (RCT)
Sample size
n = 225
Population
225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia
Methods
Double-blind trial, randomly assigned to one year of treatment with saw palmetto extract (160 mg twice a day) or placebo
Blinding
Double-blind
Duration
one year
Funding
Unclear
  • Large Human Trial
  • Highly Cited

Background

Saw palmetto is used by over 2 million men in the United States for the treatment of benign prostatic hyperplasia and is commonly recommended as an alternative to drugs approved by the Food and Drug Administration.

Methods

In this double-blind trial, we randomly assigned 225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia to one year of treatment with saw palmetto extract (160 mg twice a day) or placebo. The primary outcome measures were changes in the scores on the American Urological Association Symptom Index (AUASI) and the maximal urinary flow rate. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, quality of life, laboratory values, and the rate of reported adverse effects.

Results

There was no significant difference between the saw palmetto and placebo groups in the change in AUASI scores (mean difference, 0.04 point; 95 percent confidence interval, -0.93 to 1.01), maximal urinary flow rate (mean difference, 0.43 ml per minute; 95 percent confidence interval, -0.52 to 1.38), prostate size, residual volume after voiding, quality of life, or serum prostate-specific antigen levels during the one-year study. The incidence of side effects was similar in the two groups.

Conclusions

In this study, saw palmetto did not improve symptoms or objective measures of benign prostatic hyperplasia. (ClinicalTrials.gov number, NCT00037154.).

Research Insights

  • There was no significant difference between the saw palmetto and placebo groups in the change in ... maximal urinary flow rate (mean difference, 0.43 ml per minute; 95 percent confidence interval, -0.52 to 1.38)

    Effect
    Neutral
    Effect size
    Small
    Dose
    160 mg twice a day
  • There was no significant difference between the saw palmetto and placebo groups in the change in ... quality of life ... during the one-year study.

    Effect
    Neutral
    Effect size
    Small
    Dose
    160 mg twice a day
  • There was no significant difference between the saw palmetto and placebo groups in the change in AUASI scores (mean difference, 0.04 point; 95 percent confidence interval, -0.93 to 1.01)

    Effect
    Neutral
    Effect size
    Small
    Dose
    160 mg twice a day
  • There was no significant difference between the saw palmetto and placebo groups in the change in ... prostate size ... during the one-year study.

    Effect
    Neutral
    Effect size
    Small
    Dose
    160 mg twice a day
  • There was no significant difference between the saw palmetto and placebo groups in the change in ... residual volume after voiding ... during the one-year study.

    Effect
    Neutral
    Effect size
    Small
    Dose
    160 mg twice a day
  • There was no significant difference between the saw palmetto and placebo groups in the change in ... serum prostate-specific antigen levels during the one-year study.

    Effect
    Neutral
    Effect size
    Small
    Dose
    160 mg twice a day

Adverse Events Reported

  • saw palmetto berryOverall tolerability

    The incidence of side effects was similar in the two groups.

    Finding
    No significant difference
    Significant
    No
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