PMID- 33633825
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220420
IS  - 2040-6223 (Print)
IS  - 2040-6231 (Electronic)
IS  - 2040-6223 (Linking)
VI  - 12
DP  - 2021
TI  - Chinese traditional medicine (GuiZhi-ShaoYao-ZhiMu decoction) as an add-on 
      medication to methotrexate for rheumatoid arthritis: a meta-analysis of 
      randomized clinical trials.
PG  - 2040622321993438
LID - 10.1177/2040622321993438 [doi]
LID - 2040622321993438
AB  - BACKGROUND: GuiZhi-ShaoYao-ZhiMu decoction (GSZD), a traditional Chinese herbal 
      medication, has been frequently used as an add-on medication to methotrexate 
      (MTX) for rheumatoid arthritis (RA) treatment in China. This meta-analysis 
      evaluated the efficacy and safety of adding GSZD to MTX for RA treatment. 
      METHODS: We performed a systematic search of PubMed, Web of Science, EMBASE, and 
      the Cochrane Library (all databases) for English-language studies and WanFang, 
      VIP, and CNKI for Chinese-language studies up to 28 July 2020. Data from selected 
      studies, mainly the response rates and rate of adverse events (AEs), were 
      extracted independently by two authors, and a random-effects model 
      (Mantel-Haenszel method) was used for the meta-analysis. RESULTS: A total of 14 
      randomized controlled trials and 1224 patients were included (623 patients in the 
      GSZD + MTX group and 601 patients in the MTX group). For efficacy, the 
      meta-analysis found that combining GSZD with MTX increased the effective rate 
      [relative risk (RR) = 1.24, 95% confidence interval (CI): 1.18-1.30, based on 
      1069 patients], defined as >30% efficacy, American College of Rheumatology 20, or 
      a decrease of disease activity score 28 >0.6. Adding GSZD reduced the swollen and 
      tender joint counts, the duration of morning stiffness, the levels of C-reactive 
      protein and rheumatoid factor, and erythrocyte sedimentation rate. The adjuvant 
      therapeutic effect of GSZD was independent of the dose of MTX or the combined 
      utilization of other drugs in both groups. For safety, adding GSZD was associated 
      with a lower rate of total AEs (RR = 0.46, 95% CI: 0.26-0.83, based on 615 
      patients) and gastrointestinal tract AEs (RR = 0.46, 95% CI: 0.24-0.88, based on 
      537 patients). CONCLUSION: Combining GSZD with MTX may be a more efficacious and 
      safer strategy for treating RA compared with MTX alone. Further large studies are 
      warranted to investigate the long-term efficacy and safety of adding GSZD to MTX 
      for RA treatment.
CI  - (c) The Author(s), 2021.
FAU - Feng, Chenxi
AU  - Feng C
AD  - The Second Clinical Medical College, Zhejiang Chinese Medical University, 
      Hangzhou, Zhejiang, China.
FAU - Chen, Rongrong
AU  - Chen R
AD  - School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, 
      Zhejiang, China.
FAU - Wang, Keer
AU  - Wang K
AD  - School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, 
      Zhejiang, China.
FAU - Wen, Chengping
AU  - Wen C
AD  - School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, 
      Zhejiang, China.
FAU - Xu, Zhenghao
AU  - Xu Z
AUID- ORCID: 0000-0003-0033-525X
AD  - School of Basic Medical Science, Zhejiang Chinese Medical University, Binwen Road 
      548, Hangzhou, Zhejiang, 310053, China.
LA  - eng
PT  - Journal Article
DEP - 20210212
PL  - United States
TA  - Ther Adv Chronic Dis
JT  - Therapeutic advances in chronic disease
JID - 101532140
PMC - PMC7887670
OTO - NOTNLM
OT  - meta-analysis
OT  - methotrexate
OT  - rheumatoid arthritis
OT  - traditional Chinese medication
COIS- Conflict of interest statement: The authors declare that there is no conflict of 
      interest.
EDAT- 2021/02/27 06:00
MHDA- 2021/02/27 06:01
PMCR- 2021/02/12
CRDT- 2021/02/26 06:03
PHST- 2020/05/09 00:00 [received]
PHST- 2021/01/15 00:00 [accepted]
PHST- 2021/02/26 06:03 [entrez]
PHST- 2021/02/27 06:00 [pubmed]
PHST- 2021/02/27 06:01 [medline]
PHST- 2021/02/12 00:00 [pmc-release]
AID - 10.1177_2040622321993438 [pii]
AID - 10.1177/2040622321993438 [doi]
PST - epublish
SO  - Ther Adv Chronic Dis. 2021 Feb 12;12:2040622321993438. doi: 
      10.1177/2040622321993438. eCollection 2021.