Adjunctive treatment with oral AKL1, a botanical nutraceutical, in chronic obstructive pulmonary disease

Claire Brockwell, Sundari Ampikaipakan, Darren W. Sexton, David Price, Daryl Freeman, Mike Thomas, Muzammil Ali, Andrew M. Wilson* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
3 Downloads (Pure)


Purpose: The objective of this pilot trial was to evaluate the safety and efficacy of AKL1, a patented botanical formulation containing extracts of Picrorhiza kurroa, Ginkgo biloba, and Zingiber officinale, as add-on therapy for patients with chronic obstructive pulmonary disease (COPD) and chronic cough. Patients and methods: This randomized, double-blind, placebo-controlled trial enrolled male and female patients >18 years old with COPD and Leicester Cough Questionnaire (LCQ) score of <18. The 10-week study period comprised a 2-week single-blind placebo run-in period followed by add-on treatment with AKL1 or placebo twice daily for 8 weeks. The primary study endpoint was the change from week 0 to week 8 in cough-related health status, as assessed by the LCQ. Results: Of 33 patients enrolled, 20 were randomized to AKL1 and 13 to placebo. Patients included 19 (58%) men and 14 (42%) women of mean (standard deviation [SD]) age of 67 (9.4) years; 15 (45%) patients were smokers and 16 (49%) were ex-smokers. The mean (SD) change from baseline in LCQ score at 8 weeks was 2.3 (4.9) in the AKL1 group and 0.6 (3.7) in the placebo group, with mean difference in change of 1.8 (95% confidence interval: –1.5 to 5.1; P=0.28). The St George's Respiratory Questionnaire score improved substantially in the AKL1 treatment group by a mean (SD) of –7.7 (11.7) versus worsening in the placebo group (+1.5 [9.3]), with mean difference in change of –9.2 (95% confidence interval: –19.0 to 0.6; P=0.064). There were no significant differences between treatment groups in change from baseline to week 8 in other patient-reported measures, lung function, or the 6-minute walk distance. Conclusion: Further study is needed with a larger patient population and over a longer duration to better assess the effects of add-on therapy with AKL1 in COPD.
Original languageEnglish
Pages (from-to)715—721
Number of pages7
JournalInternational journal of chronic obstructive pulmonary disease
Issue number1
Early online date9 Jul 2014
Publication statusPublished - 12 Dec 2014

Bibliographical note

Assistance with the statistical analyses was provided by Stanley D Musgrave, MD. Editorial assistance was provided by Elizabeth V Hillyer, DVM, ELS. This research was funded by UK Respiratory Research Foundation (UKRRF) of the International Primary Care Respiratory Group (IPCRG).


  • Leicester Cough Questionnaire
  • anti-inflammatory
  • Picrorhiza kurroa
  • Ginkgo biloba
  • Zingiber officinale


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