Effect of the Japanese herbal drug rikkunshito for the treatment of malnutrition in patients with chronic heart failure

Aim: Although malnutrition is an important prognostic factor in patients with chronic heart failure (CHF), no effective treatment for malnutrition has been established. Rikkunshito (RKT) is a Japanese herbal drug that has been used in daily practice for patients with loss of appetite. However, no data have demonstrated whether or not RKT can improve the body composition in patients with CHF. The aim of this study was to elucidate the effect of RKT on the nutritional status of patients with CHF. Methods: This single-center retrospective observational study included 14 patients with CHF and loss of appetite who were treated with RKT. Body mass index (BMI) and body composition including fat-free mass index (FFMI), skeletal muscle mass index (SMI) and fat mass index (FMI) were measured by the bioimpedance method. Body composition was measured at baseline and 12 weeks later. The primary endpoint was the change of BMI and body composition. Results: BMI was significantly improved from 23.7 (20.0-26.1) kg/m(2) to 24.2 (20.3-27.3) kg/m(2) (p = 0.0494). FFMI was significantly improved from 13.7 (11.3-14.9) kg/m(2) to 14.2 (12.0-15.7) kg/m(2) (p = 0.0002). SMI was also improved from 5.0 (3.0-6.2) kg/m(2) to 5.3 (3.3-6.8) kg/m(2) (p = 0.0085). On the other hand, FMI was not significantly changed (9.4 (7.2-12.0) kg/m(2) to 10.3 (7.9-12.0) kg/m(2), p = 0.8552). Conclusion: The Japanese herbal drug RKT was effective in improving the nutritional status of patients with CHF.