Delving into the Latest Updates on Renshen Yangrong Tang with Synapse

Overview

Basic Info

Drug Type

Herbal medicine

Synonyms

Ninjin'yoeito, RSYRT decoction

Target-

Mechanism-

Therapeutic Areas

Digestive System DisordersHemic and Lymphatic DiseasesOther Diseases

Active Indication

AnemiaAnxiety DisordersDecrease in appetite

Inactive Indication-

Originator Organization

Ohsugi Pharmaceutical Co., Ltd.

Active Organization

Ohsugi Pharmaceutical Co., Ltd.

Inactive Organization-

Drug Highest PhaseApproved

First Approval Date

JP (22 Aug 1986),

AnemiaAnxiety DisordersDecrease in appetite

Regulation-

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Introduction In geriatric medicine, there is currently significant attention on frailty, a condition commonly associated with aging and characterized by muscle weakness and other age-related changes. Within the fields of urology and gynecology, conditions such as overactive bladder (OAB) and genitourinary syndrome of menopause (GSM) have been identified as crucial concerns due to their negative impact on the quality of life of elderly individuals. In this study, we investigated the potential of Ninjin'yoeito (NYT), a traditional Chinese herbal medicine, as a viable treatment option for frailty. Additionally, we hypothesized that NYT may also contribute to the improvement of symptoms associated with OAB and GSM, and potentially help in reducing the dosage of OAB medications. Methods In this retrospective cohort study conducted from November 2016 to November 2022, we created a website describing the relationship between frailty and genitourinary symptoms in frail patients aged ≥ 65 years with GSM who underwent pelvic floor muscle training. The patients were divided into two propensity score-matched groups: NYT group (received NYT for one year) and no-NYT group (did not receive NYT), based on their wishes. The fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) scale was used to assess frailty status. Urinary symptoms were evaluated using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and Overactive Bladder Symptom Score (OABSS). Genital symptoms were investigated using the vaginal health index score and vulvodynia swab test. The value of each score was obtained before (T0) and 12 months after (T12) treatment, and the difference (Δ_T0/T12) was calculated. Results During the study period, 985 outpatients visited our clinic, of whom 725 were considered frail/pre-frail; 402 women with frailty/pre-frailty (mean age 77.5 ± 6.49 years) were included, with a median follow-up of 14.5 months. The NYT and no-NYT groups had 220 and 182 patients, respectively. After propensity score matching, each group had 159 patients. Δ_T0/T12FRAIL scale score was significantly higher in the NYT group (0.13 ± 0.37) than in the no-NYT (0.01 ± 0.10) group (p=0.001.) However, urinary symptoms improved in the NYT group more than in the no-NYT in terms of the following parameters: Δ_T0/T12OABSS (NYT: 0.89 ± 1.65; no-NYTl: 0.36 ± 1.14, p=0.001) and Δ_T0/T12ICIQ-SF score (NYT: 1.51 ± 1.75; no-NYT: 0.42 ± 1.18, p<0.001). Genital symptoms were better in the NYT group in terms of _ΔT0/T12VHIS (NYT: 0.58 ±1.08; no-NYT: 0.21 ±0.65, p<0.001). The vulvodynia swab test showed improvements in left para-hymen evoked pain in both groups. In the NYT group, 5% of the patients underwent antimuscarinic drug dose reduction for overactive bladder treatment. NYT use was not associated with significant side effects, and only 0.6% of patients reported drug allergies. Conclusion NYT improved activity levels in frail/pre-frail patients. Moreover, NYT use improved various genitourinary symptoms experienced by patients with frailty/pre-frailty. Treatment with NYT may reduce the dose of overactive bladder medications. The anticholinergic load-reducing effect of NYT may help solve the problem of polypharmacy.

01 Apr 2023·Journal of Pharmaceutical and Biomedical Analysis

Qualitative and quantitative analysis of major components of Renshen-Yangrong Pill by UPLC-LTQ/Orbitrap/MS and UPLC-MS/MS

Article

Author: Zhu, Yao ; Liu, Ping ; Jiang, Xue-Lian ; Ma, Gai-Fan ; Chen, Lin-Lin

Renshen-Yangrong Pill (RYP) is a classical traditional Chinese medicine (TCM) preparation for the treatment of asthenic symptoms, while its multiple herbal compositions bring a wide variety of unclear chemical components which seriously hinder the effective quality control and clinical practice. The present study aimed to investigate the overall chemical profile of RYP by UPLC-LTQ/Orbitrap/MS, and further obtain the quantitative distributions of representing components in the preparations. A total of 132 components in RYP including flavonoids, triterpenoid saponins, phenylpropanoids, and monoterpenoid glycosides were identified or tentatively characterized by authentic compounds or accurate masses and fragmentation, in which 52 characteristic components were selected for further quantitation by UPLC-MS/MS. The assay was validated in terms of linearity, precision, repeatability, recovery and successfully applied for the quality control of 40 batches of RYP. Hesperidin and paeoniflorin were revealed as the most abundant constituents in RYP, and the samples of different origins and dosage forms were clearly classified based on hierarchical cluster analysis. This study provided a deep insight into the chemical profiling of RYP, as well as a new approach for determining the marker compounds, which laid a valuable foundation for further investigation of potential effective components and comprehensive quality control of RYP and related preparations.

01 Jan 2023·Evidence-Based Complementary and Alternative Medicine

Effects of Ninjin’yoeito on Human CYP3A and Mouse CYP3A Activity

Article

Author: Han, Li-Kun ; Yoshimi, Takashi ; Michihara, Seiwa ; Oyama, Manami ; Kaneda, Marisa ; Fujita, Nina ; Takahashi, Ryuji

Ninjin’yoeito (NYT) is widely used clinically for the management of patients with frailty and other multiple symptoms. NYT is often administered with other drugs; however, little information is available on its drug interactions. Previous studies using human liver microsomes have reported that constituents of NYT either inhibit (schisandra fruit, cinnamon bark, glycyrrhiza, and poria sclerotium) or induce (schisandra fruit and glycyrrhiza) CYP3A4 expression. Herein, we conducted in vitro and in vivo studies targeting human CYP3A and mouse CYP3A to elucidate the effects of NYT coadministration with other drugs on hepatic drug metabolism. In an inhibition study using human liver microsomes, NYT showed concentration‐dependent reversible inhibition and time‐dependent inhibition. Furthermore, in an induction study using frozen human hepatocytes, the addition of 0.01–0.1 mg/mL NYT resulted in a concentration‐dependent increase in CYP3A gene expression. Contrarily, no significant changes in CYP3A substrate blood concentrations were observed between untreated mice and mice that received either a single dose of NYT or repeated doses for 15 days. These results demonstrate that NYT has inhibitory and inductive effects on hepatic CYP3A in vitro, but orally administered NYT does not affect drug metabolism mediated by hepatic CYP3A in vivo in the mouse model. Although there is a little information about drug interactions of NYT, this study provides new evidence for that.

100 Deals associated with Renshen Yangrong Tang

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R&D Status

10 top approved records.

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Indication	Country/Location	Organization	Date
Anemia	JP	Ohsugi Pharmaceutical Co., Ltd.	22 Aug 1986
Anxiety Disorders	JP	Ohsugi Pharmaceutical Co., Ltd.	22 Aug 1986
Decrease in appetite	JP	Ohsugi Pharmaceutical Co., Ltd.	22 Aug 1986

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT03911921 (Pubmed \| J Pain Symptom Manage)	Phase 2	Fatigue \| Neoplasms	83	Renshen Yangrong Tang Herbal Extract Granules	(xkcreakkmq) = bdgjqyftjt vsshdfxdyl (xvnbtjiyph )	Positive	01 May 2020
				Low dose of single herb (huangqi)	(xkcreakkmq) = ngcmgqemle vsshdfxdyl (xvnbtjiyph )