PMID- 36028187
OWN - NLM
STAT- MEDLINE
DCOM- 20221017
LR  - 20221017
IS  - 1096-1186 (Electronic)
IS  - 1043-6618 (Linking)
VI  - 184
DP  - 2022 Oct
TI  - Efficacy of tripterygium glycosides (TG) in rheumatoid arthritis as a 
      disease-modifying anti-rheumatic drug (DMARD) in combination with conventional 
      DMARDs: A systematic review and meta-analysis of randomized controlled trials.
PG  - 106405
LID - S1043-6618(22)00350-4 [pii]
LID - 10.1016/j.phrs.2022.106405 [doi]
AB  - OBJECTIVES: To explore efficacy and safety, as well as efficacy mechanisms, main 
      efficacy characteristics, and efficacy influencing factors of TG, in combination 
      with one conventional DMARD, to provide guidance for the clinical application of 
      TG in treating RA. METHODS: We searched the databases of PubMed, Embase, Web of 
      Science, Cochrane Library, Ovid, Scopus, Clinicaltrials.gov, CNKI, Wanfang, 
      SinoMed, VIP, Chinese Clinical Trial Registry, KTKP, and J-STAGE to August 12, 
      2022. All included studies were analyzed with Stata 16.0 software and Review 
      Manager 5.4 software according to the PRISMA Statement. RESULTS: Thirty-eight 
      randomized controlled trials (RCTs) were included. Combined TG was superior in 
      28-joint count Disease Activity Score (DAS28) and American College of 
      Rheumatology 50 response (ACR50) and did not increase adverse events (AEs). 
      Combined TG significantly suppressed interleukin-1 (IL-1), interleukin-6 (IL-6), 
      and tumor necrosis factor-alpha (TNF-alpha). And combined TG showed significant 
      advantages in improving tender joint count (TJC), swollen joint count (SJC), pain 
      score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and 
      physician's and patient's global assessments of disease activity. However, the 
      average age of the intervention population, treatment course, the combined DMARDs 
      category, and the risk of bias were important factors influencing the above 
      effects. CONCLUSIONS: The combination of TG is superior to conventional DMARD 
      monotherapy in improving RA conditions with a good safety profile. This effect is 
      closely related to the mechanism of TG reducing IL-1, IL-6 and TNF-alpha. And the 
      combination of TG shows better effect in all aspects such as improving joint 
      signs, symptoms, inflammatory indicators, and overall health. But for those under 
      45 years of age, with short-term intermittent dosing, in combination with MTX may 
      be more beneficial for TG to show better efficacy.
CI  - Copyright (c) 2022 Elsevier Ltd. All rights reserved.
FAU - Feng, Zhe
AU  - Feng Z
AD  - The First Clinical Medical College, Nanjing University of Chinese Medicine, 
      Nanjing 210023, China. Electronic address: 260583@njucm.edu.cn.
FAU - Fu, Ling
AU  - Fu L
AD  - Department of Diabetes and Cancer Metabolism, City of Hope National Medical 
      Center, Duarte, CA 91010, USA.
FAU - Wang, Junqin
AU  - Wang J
AD  - School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese 
      Medicine, Nanjing 210023, China.
FAU - Zhu, Yamei
AU  - Zhu Y
AD  - Department of Rheumatology, Nanjing Hospital of Chinese Medicine Affiliated to 
      Nanjing University of Chinese Medicine, Nanjing 210001, China.
FAU - He, Xiaojin
AU  - He X
AD  - The First Clinical Medical College, Nanjing University of Chinese Medicine, 
      Nanjing 210023, China.
FAU - Zhou, Lingling
AU  - Zhou L
AD  - College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, 
      China.
FAU - Zhou, Xueping
AU  - Zhou X
AD  - The First Clinical Medical College, Nanjing University of Chinese Medicine, 
      Nanjing 210023, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20220824
PL  - Netherlands
TA  - Pharmacol Res
JT  - Pharmacological research
JID - 8907422
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Glycosides)
RN  - 0 (Interleukin-1)
RN  - 0 (Interleukin-6)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - *Antirheumatic Agents/adverse effects
MH  - *Arthritis, Rheumatoid/drug therapy
MH  - C-Reactive Protein
MH  - Glycosides/therapeutic use
MH  - Humans
MH  - Interleukin-1
MH  - Interleukin-6
MH  - Methotrexate/therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
MH  - Tripterygium
MH  - Tumor Necrosis Factor-alpha
OTO - NOTNLM
OT  - Efficacy
OT  - Meta-analysis
OT  - Rheumatoid arthritis
OT  - Safety
OT  - Tripterygium glycosides
COIS- Conflict of interest statement The authors declared no potential conflicts of 
      interest in this research.
EDAT- 2022/08/27 06:00
MHDA- 2022/10/18 06:00
CRDT- 2022/08/26 19:27
PHST- 2022/06/12 00:00 [received]
PHST- 2022/08/16 00:00 [revised]
PHST- 2022/08/16 00:00 [accepted]
PHST- 2022/08/27 06:00 [pubmed]
PHST- 2022/10/18 06:00 [medline]
PHST- 2022/08/26 19:27 [entrez]
AID - S1043-6618(22)00350-4 [pii]
AID - 10.1016/j.phrs.2022.106405 [doi]
PST - ppublish
SO  - Pharmacol Res. 2022 Oct;184:106405. doi: 10.1016/j.phrs.2022.106405. Epub 2022 
      Aug 24.