PMID- 31178729
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 10
DP  - 2019
TI  - The Effectiveness and Safety of Total Glucosides of Paeony in Primary Sjogren's 
      Syndrome: A Systematic Review and Meta-Analysis.
PG  - 550
LID - 10.3389/fphar.2019.00550 [doi]
LID - 550
AB  - Objective: To assess the effectiveness and safety of the total glucosides of 
      paeony (TGP) on the treatment of primary Sjogren's syndrome (pSS) by conducting a 
      meta-analysis. Methods: Eight databases were searched from their inception to 
      December 10, 2018 for randomized controlled trials (RCTs). The Revman 5.3 
      software was used for this meta-analysis. Results: Nine RCTs which included 770 
      participants were identified. Pooled results showed that significant difference 
      in Schirmer's test (P < 0.00001) comparing TGP with placebo (PBO). However, the 
      pooled results displayed significant differences in salivary flow rate, 
      Schirmer's test, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), 
      rheumatoid factor (RF), serum gamma-globulin, immunoglobulin G (IgG), IgA, IgM, and 
      effective rate (P </= 0.01) in the co-administration of TGP with immunosuppressant 
      (IS) compared with IS alone. Subgroup analyses revealed both heterogeneities in 
      ESR and serum gamma-globulin were eliminated, showing combined intervention of TGP + 
      IS being more advantageous than single usage of IS (P < 0.00001). However, the 
      advantage varied among three subgroups and showed a gradual weakening over time. 
      Furthermore, our results showed statistical significance in Schirmer's test (P = 
      0.0006), when hydroxychloroquine (HCQ) was jointly applied, but not in the case 
      of combined TGP with methotrexate (MTX) (P = 0.41). For the safety analysis, the 
      most common adverse events (AEs) were diarrhea or gastrointestinal discomfort, 
      and no severe AEs were reported in TGP group. Meanwhile, six trials showed 
      statistically insignificant differences between TGP + IS and IS in AEs (P = 
      0.76). Conclusions: Improving the lacrimal gland secretion (Schirmer's test) is 
      the prominent function of TGP compared with PBO. TGP + IS can improve the 
      clinical symptoms, such as lacrimal and salivary gland secretion function 
      (Schirmer's test, salivary flow rate), inflammatory indices (ESR, CRP, and RF) 
      and immunoglobulins (gamma-globulin, IgG, IgA, and IgM) on the basis of IS 
      monotherapy. In addition, TGP has an acceptable safety profile and AEs were not 
      increased when TGP combined with IS in pSS. Therefore, TGP can be considered to 
      be a potentially valid and safe drug for the treatment of pSS in the clinic. In 
      view of the limitations of the included trials, the potential beneficial 
      effectiveness and safety of TGP need additional high-quality, multi-center, and 
      large-scale RCTs to assess its use in pSS treatment.
FAU - Feng, Zhe
AU  - Feng Z
AD  - The First Clinical Medical College, Nanjing University of Chinese Medicine, 
      Nanjing, China.
FAU - Zhang, Bi-Qing
AU  - Zhang BQ
AD  - Department of Traditional Chinese Medicine, The Third Affiliated Hospital of 
      Soochow University, The First People's Hospital of Changzhou, Changzhou, China.
FAU - Zhu, Ya-Mei
AU  - Zhu YM
AD  - Department of Rheumatology, Nanjing Hospital of Chinese Medicine, The Third 
      Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
FAU - Yu, Bei-Bei
AU  - Yu BB
AD  - School of Foreign Languages, Nanjing University of Chinese Medicine, Nanjing, 
      China.
FAU - Fu, Ling
AU  - Fu L
AD  - The First Clinical Medical College, Nanjing University of Chinese Medicine, 
      Nanjing, China.
FAU - Zhou, Ling-Ling
AU  - Zhou LL
AD  - Jiangsu Provincial Key Laboratory of Pharmacology and Safety Evaluation of 
      Material Medica, School of Pharmacy, Nanjing University of Chinese Medicine, 
      Nanjing, China.
FAU - Zhou, Xue-Ping
AU  - Zhou XP
AD  - The First Clinical Medical College, Nanjing University of Chinese Medicine, 
      Nanjing, China.
FAU - Lu, Yan
AU  - Lu Y
AD  - Department of Rheumatology, Affiliated Hospital of Nanjing University of TCM, 
      Jiangsu Province Hospital of TCM, Nanjing, China.
LA  - eng
PT  - Systematic Review
DEP - 20190524
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC6543198
OTO - NOTNLM
OT  - effectiveness
OT  - meta-analysis
OT  - primary Sjogren's syndrome
OT  - safety
OT  - the total glucosides of paeony
EDAT- 2019/06/11 06:00
MHDA- 2019/06/11 06:01
PMCR- 2019/05/24
CRDT- 2019/06/11 06:00
PHST- 2019/02/03 00:00 [received]
PHST- 2019/05/01 00:00 [accepted]
PHST- 2019/06/11 06:00 [entrez]
PHST- 2019/06/11 06:00 [pubmed]
PHST- 2019/06/11 06:01 [medline]
PHST- 2019/05/24 00:00 [pmc-release]
AID - 10.3389/fphar.2019.00550 [doi]
PST - epublish
SO  - Front Pharmacol. 2019 May 24;10:550. doi: 10.3389/fphar.2019.00550. eCollection 
      2019.