Efficacy and safety of ephedra-containing oral medications: a systematic review, meta-analysis, and exploratory dose–response analysis for weight reduction
What this study found
Ephedra-containing oral medications produced statistically significant weight loss benefits versus control. Across the pooled trials, treatment was associated with reductions in BMI, body weight, and waist circumference, and the exploratory analysis suggested a dose-response relationship in which daily ephedrine dose and treatment duration contributed to effect heterogeneity. Adverse events and dropouts did not differ significantly between groups, suggesting acceptable safety within the FDA-recommended daily ephedrine dose range when medically supervised. The authors cautioned that the…
- Study & population
- Systematic review, meta-analysis, and exploratory dose-response analysis of 16 randomized controlled trials in overweight or obese adults with BMI at least 25 from Korea, the United States, Japan, and China.
- Intervention
- Ephedra-containing oral medications were given by mouth in varying formulations, including ephedra alone or ephedra combined with other herbs or dietary supplements.
- Key limitation
- The evidence base was limited by a small number of randomized trials, heterogeneous ephedra-containing formulations and doses, and inconsistent reporting of key outcome data.
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Open PDFOriginal abstract
Introduction Despite the widespread use of ephedra in various forms, including food supplements and herbal prescriptions, comprehensive studies reviewing its efficacy and safety across different countries are lacking. Methods We systematically searched 5 electronic databases and conducted a meta-analysis of 16 randomized controlled trials (RCTs) on ephedra-containing oral medications (EOMs), performing a dose–response analysis for weight loss. Results The meta-analysis results revealed a statistically significant reduction in the body mass index (BMI) (MD: 1.5 kg/m2; 95% CI: −2.46 to −0.54) and secondary outcomes like body weight (BW) and waist circumference (WC). The dose–response analysis indicated a correlation between ephedra and weight reduction. The safety analysis showed no significant difference in adverse effects between the treatment and control groups (RR = 0.99, 95% CI = 0.80 ∼ 1.21, and p = 0.90). Discussion In conclusion, EOMs demonstrated effectiveness in promoting weight loss, and the dose–response analysis indicated a correlation between ephedra and weight reduction. However, additional research is necessary due to the limited number of studies and inconsistent results among the assessment criteria. Moreover, if prescribed by traditional medicine physicians within the permissible daily ephedrine dosage range of 150 mg set by the Food and Drug Administration (FDA) and monitored by healthcare professionals, the risk of severe adverse events is likely to be minimal. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=387895, identifier CRD42023387895.