PMID- 33120813 OWN - NLM STAT- MEDLINE DCOM- 20201231 LR - 20221005 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 99 IP - 43 DP - 2020 Oct 23 TI - Effect of downregulation of serum MMP-3 levels by traditional Chinese medicine ingredients combined with methotrexate on the progression of bone injury in patients with rheumatoid arthritis: A protocol for a systematic review and meta-analysis. PG - e22841 LID - 10.1097/MD.0000000000022841 [doi] LID - e22841 AB - BACKGROUND: A large number of clinical studies have confirmed that after treatment with traditional Chinese medicine components such as sinomenine (SIN), the matrix -metalloproteinase3 (MMP-3) level of patients with rheumatoid arthritis (RA) shows a significant decrease, whereas MMP-3 can be involved in degrading bone matrix in humans, so in the progression of bone and joint injury in patients with RA, serum MMP-3 can be used as an important biochemical marker. The traditional Chinese medicine components commonly used in clinical practice include total glucosides of paeony (TGP), SIN, and tripterygium glycosides, which have the characteristics of disease-modifyinganti-rheumatic drugs and non-steroidal anti-inflammatory drugs, while they can reduce the toxic side effects of methotrexate (MTX), and their combination with other drugs such as MTX and leflunomide (HWA486) has become an important regimen for the treatment of RA in clinical practice. Therefore, we designed this study protocol to evaluate the adjuvant effect of commonly used traditional Chinese medicine components combined with MTX in the treatment of osteoarticular injury in RA. METHODS: The search time was set from January 2000 to September 2020 in this study. EMBASE database, Cochrane Library, PubMed, Web of Science, Science Direct, Chinese National Knowledge Infrastructure, China Biology Medicine disc (CBM), Chinese Scientifific Journals Database (VIP), and Wanfang Database were used as search sources to select the traditional Chinese medicine components that reduce MMP-3 and use MTX in the treatment of RA. Clinical randomized controlled trials were used, and inclusion criteria and exclusion criteria were set for screening. In this study, MMP-3, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), cyclic peptide containing citrulline (CCP) and rheumatoid factor (RF) were used as the main outcomes, and the improvement of Disease Activity Score 28 (DAS28), joint bone mineral density, Clinical Disease Activity Index (CDAI), and other clinically relevant symptoms was selected as the secondary outcomes. Revman software version 5.3 was used for statistical analysis of data and risk assessment of deviation in this meta-analysis. In this study, one researcher performed study direction selection, literature inquiry, and literature download, and 2 independent reviewers performed literature data extraction and literature quality assessment. Dichotomized data are expressed as relative risk, continuous data are expressed as mean difference or standard mean difference, and finally fixed-effect model or random-effect model is used for synthesis according to the heterogeneity of data. RESULTS: To evaluate the effect of downregulation of MMP-3 level by traditional Chinese medicine components combined with MTX on the progression of bone injury in patients with RA by serum MMP-3, ESR, CRP, CCP, and RF. CONCLUSION: This study protocol can be used to evaluate the efficacy and safety of traditional Chinese medicine components combined with MTX in the treatment of bone injury in patients with RA. ETHICS AND DISSEMINATION: This study is a secondary study based on the published clinical research; therefore, approval from an ethics committee is not required for this study. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P), the results of this study will be published in peer-reviewed scientific journals and conference papers. REGISTRATION NUMBER:: is INPLASY202090064. FAU - Sun, Yue AU - Sun Y AD - College of Basic Medicine. FAU - Huang, Yucheng AU - Huang Y AD - College of Clinical Medicine. FAU - Chen, Tiantian AU - Chen T AD - Department of Rheumatology, Hospital of Chengdu University of Traditional Chinese Medicine. FAU - Li, Xueping AU - Li X AD - College of Basic Medicine. FAU - Chen, Jiayi AU - Chen J AD - Department of Rheumatology, Hospital of Chengdu University of Traditional Chinese Medicine. FAU - Wang, Zhuozhi AU - Wang Z AD - College of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China. FAU - Lin, Kexin AU - Lin K AD - College of Clinical Medicine. FAU - Gao, Yongxiang AU - Gao Y AUID- ORCID: 0000-0002-6921-9006 AD - College of Basic Medicine. AD - College of Clinical Medicine. AD - Department of Rheumatology, Hospital of Chengdu University of Traditional Chinese Medicine. AD - College of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China. FAU - He, Lisha AU - He L AD - College of Basic Medicine. AD - College of Clinical Medicine. AD - Department of Rheumatology, Hospital of Chengdu University of Traditional Chinese Medicine. AD - College of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, P.R. China. LA - eng PT - Journal Article PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R RN - 0 (Antirheumatic Agents) RN - 0 (Drugs, Chinese Herbal) RN - EC 3.4.24.17 (Matrix Metalloproteinase 3) RN - YL5FZ2Y5U1 (Methotrexate) SB - IM MH - Antirheumatic Agents/*therapeutic use MH - Bone and Bones/drug effects MH - Disease Progression MH - Down-Regulation/drug effects MH - Drugs, Chinese Herbal/*therapeutic use MH - Humans MH - Matrix Metalloproteinase 3/blood/*drug effects MH - Medicine, Chinese Traditional/methods MH - Methotrexate/*therapeutic use MH - Systematic Reviews as Topic PMC - PMC7581142 COIS- The authors report no conflicts of interests. EDAT- 2020/10/31 06:00 MHDA- 2021/01/01 06:00 PMCR- 2020/10/23 CRDT- 2020/10/30 01:01 PHST- 2020/10/30 01:01 [entrez] PHST- 2020/10/31 06:00 [pubmed] PHST- 2021/01/01 06:00 [medline] PHST- 2020/10/23 00:00 [pmc-release] AID - 00005792-202010230-00089 [pii] AID - MD-D-20-09266 [pii] AID - 10.1097/MD.0000000000022841 [doi] PST - ppublish SO - Medicine (Baltimore). 2020 Oct 23;99(43):e22841. doi: 10.1097/MD.0000000000022841.