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In reply

Dr Lee has raised an important point regarding the long-term safety of butterbur therapy. To my knowledge, the longest (published) treatment period with any butterbur preparation has been 16 weeks.¹ Normally, this length of time would be sufficient for the treatment of a seasonal condition such as intermittent allergic rhinitis. However, the fact remains that formal long-term safety data are lacking and are urgently needed. Until such data are available, and in view of the excellent results in short-term studies, my colleagues and I have limited our use of butterbur (leaf extract) to short-term treatments of no more than 16 weeks (typically 8-12 weeks), according to patient response and tolerability. Importantly, long-term data, when obtained, may not be transferable to all butterbur formulations, as the toxicity potential of root extracts as used in some of the published studies (compare references 3-5 in Dr Lee's letter and reference 1 . . . [Full Text of this Article]

AUTHOR INFORMATION
Andreas Schapowal, MD, PhD, DSc, Hon

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