PMID- 33915947
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210502
IS  - 1999-4923 (Print)
IS  - 1999-4923 (Electronic)
IS  - 1999-4923 (Linking)
VI  - 13
IP  - 4
DP  - 2021 Apr 1
TI  - Integrative Medicine (Herbal Medicine Combined with Drug Therapy) for Behcet's 
      Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
LID - 10.3390/pharmaceutics13040476 [doi]
LID - 476
AB  - This review aimed to investigate the efficacy of integrative medicine (herbal 
      medicine combined with drug therapy) in the treatment of Behcet's disease (BD). 
      Eleven databases were searched from their inception to 7 December 2020, for 
      randomized control trials (RCTs) that reported the effects of integrative 
      medicine in treating BD. The risk of bias was assessed using seven domain 
      criteria from the Cochrane Collaboration tool. Grading of Recommendations 
      Assessment, Development, and Evaluation (GRADE) was used to assess the quality of 
      evidence. The direction of the effect is also shown in the form of an albatross 
      plot. Sixteen trials met the inclusion criteria and were analyzed. The overall 
      risk of bias was determined to be uncertain. The meta-analysis showed a superior 
      response rate with herbal medicine plus drug therapy (relative risk (RR) 1.19, 
      95% confidence interval (CI) 1.13 to 1.25, n = 1034, p < 0.00001, I(2) = 0%, low 
      certainty of evidence (CoE)) compared to drug therapy. Integrative medicine also 
      lowered the recurrence rate after 2 months of follow-up (RR 0.27, 95% CI 0.09 to 
      0.76, n = 120, p = 0.01, I(2) = 0%, low CoE). The erythrocyte sedimentation rate 
      (ESR), C-reactive protein (CRP) level, and skin lesions were also significantly 
      improved using integrative medicine, but equivalent effects were seen for oral 
      ulcers, genital ulcers, and eye inflammation. Minor adverse events were reported 
      in both groups. Our findings suggest that herbal medicine combined with drug 
      therapy is more effective for the treatment of BD than drug therapy alone. 
      Although the type of drug therapy used varied across the studies, integrative 
      medicine was shown to improve the total response rate, skin lesions, the ESR, and 
      the CRP level. However, the overall risk of bias of the studies was concerning, 
      and the CoE was low. Information on adverse events (AEs) was also insufficient. 
      In addition, the number of studies included for data synthesis for most outcomes 
      was small. Future studies with rigorous RCTs may help establish the efficacy of 
      integrative medicine in the treatment of BD.
FAU - Jun, Ji Hee
AU  - Jun JH
AUID- ORCID: 0000-0001-9084-903X
AD  - Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 
      Yuseongdae-ro, Yuseong-gu, Daejeon 34054, Korea.
FAU - Ang, Lin
AU  - Ang L
AUID- ORCID: 0000-0002-7273-9600
AD  - Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 
      Yuseongdae-ro, Yuseong-gu, Daejeon 34054, Korea.
AD  - Korean Convergence Medicine, University of Science and Technology, Daejeon 34113, 
      Korea.
FAU - Choi, Tae Young
AU  - Choi TY
AUID- ORCID: 0000-0003-0638-2153
AD  - Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 
      Yuseongdae-ro, Yuseong-gu, Daejeon 34054, Korea.
FAU - Lee, Hye Won
AU  - Lee HW
AUID- ORCID: 0000-0003-4248-1482
AD  - Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 
      34054, Korea.
FAU - Lee, Myeong Soo
AU  - Lee MS
AUID- ORCID: 0000-0001-6651-7641
AD  - Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 
      Yuseongdae-ro, Yuseong-gu, Daejeon 34054, Korea.
AD  - Korean Convergence Medicine, University of Science and Technology, Daejeon 34113, 
      Korea.
LA  - eng
GR  - G17250, KSN2013210, and KSN2021210/Korea Institute of Oriental Medicine/
GR  - 1465025215/Ministry of Health and Welfare/
PT  - Journal Article
PT  - Review
DEP - 20210401
PL  - Switzerland
TA  - Pharmaceutics
JT  - Pharmaceutics
JID - 101534003
PMC - PMC8065893
OTO - NOTNLM
OT  - Behcet's disease
OT  - complementary and alternative medicine
OT  - herbal medicine
OT  - integrative medicine
OT  - systematic review
COIS- The authors have no conflict of interest to disclose.
EDAT- 2021/05/01 06:00
MHDA- 2021/05/01 06:01
PMCR- 2021/04/01
CRDT- 2021/04/30 01:01
PHST- 2021/03/11 00:00 [received]
PHST- 2021/03/26 00:00 [revised]
PHST- 2021/03/30 00:00 [accepted]
PHST- 2021/04/30 01:01 [entrez]
PHST- 2021/05/01 06:00 [pubmed]
PHST- 2021/05/01 06:01 [medline]
PHST- 2021/04/01 00:00 [pmc-release]
AID - pharmaceutics13040476 [pii]
AID - pharmaceutics-13-00476 [pii]
AID - 10.3390/pharmaceutics13040476 [doi]
PST - epublish
SO  - Pharmaceutics. 2021 Apr 1;13(4):476. doi: 10.3390/pharmaceutics13040476.