PMID- 36081815
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220912
IS  - 2225-4110 (Print)
IS  - 2225-4110 (Electronic)
IS  - 2225-4110 (Linking)
VI  - 12
IP  - 5
DP  - 2022 Sep
TI  - Conventional disease-modifying anti-rheumatic drugs combined with Chinese Herbal 
      Medicines for rheumatoid arthritis: A systematic review and meta-analysis.
PG  - 437-446
LID - 10.1016/j.jtcme.2022.01.005 [doi]
AB  - Rheumatoid Arthritis (RA) remains a major global public health challenge. 
      Disease-modifying anti-rheumatic drugs (DMARDs) are standard therapeutic drugs 
      for RA. Conventional DMARDs (c-DMARDs) are a subgroup of approved synthetic 
      DMARDs. The c-DMARDs experienced lesser response with longer disease duration or 
      drug exposure, and unwanted adverse events (AEs). The combination treatments 
      (CTs) of c-DMARDs and Chinese Herbal Medicines (CHMs) were often used in RA 
      clinical trials for increasing the therapeutic effectiveness and reducing the 
      AEs. This systematic review aimed to evaluate the efficacy and safety of the CTs 
      for RA. Databases were searched from inception to October 2020 for identification 
      of randomized controlled trials (RCTs) that investigated the CTs in the 
      management of RA. Twenty-three RCTs with 2,441 participants were included. The 
      assessments and analyses found CTs improved American College of Rheumatology 
      (ACR) 20 (RR: 1.33, 95% CI [1.21, 1.45], 10 studies, n=1,075) and alleviated AEs 
      (RR: -0.40, 95% CI [-0.30, -0.53], 19 studies, n=2,011) in comparison with 
      c-DMARDs. The CTs also significantly improved RA symptoms and patient-reported 
      outcomes; reduced disease activity score (DAS) 28, serum acute-phase reactants 
      and RA biomarkers. The five most commonly used herbs in included studies were 
      Angelicae Sinensis Radix, Paeoniae Radix Alba, Cinnamomi Ramulus, Glycyrrhizae 
      Radix et Rhizoma, and Clematidis Radix et Rhizoma. Pharmacological studies 
      indicated these CHMs could contribute to the outcomes. The integrated CHMs 
      potentially increased the overall effectiveness of c-DMARDs and alleviated AEs in 
      management of RA. Large sample and rigorously designed RCTs are required for 
      future studies.
CI  - (c) 2022 Center for Food and Biomolecules, National Taiwan University. Production 
      and hosting by Elsevier Taiwan LLC.
FAU - Han, Rong
AU  - Han R
AD  - Hong Kong Polytechnic University, Faculty of Engineering, Department of 
      Biomedical Engineering, Hong Kong.
FAU - Ren, Hong Cheng
AU  - Ren HC
AD  - Hong Kong Polytechnic University, Faculty of Engineering, Department of 
      Biomedical Engineering, Hong Kong.
FAU - Zhou, Sitong
AU  - Zhou S
AD  - Hong Kong Polytechnic University, Faculty of Engineering, Department of 
      Biomedical Engineering, Hong Kong.
FAU - Gu, Sherman
AU  - Gu S
AD  - Knox Chinese Healing & Myotherapy, Melbourne, VIC, Australia.
FAU - Gu, Yue-Yu
AU  - Gu YY
AD  - The Second Clinical College, Guangzhou University of Chinese Medicine and 
      Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510080, 
      China.
FAU - Sze, Daniel Man-Yuen
AU  - Sze DM
AD  - School of Health and Biomedical Science, RMIT University, Melbourne, Australia.
FAU - Chen, Meng-Hua
AU  - Chen MH
AD  - School of Health and Biomedical Science, RMIT University, Melbourne, Australia.
AD  - Aussway Chinese Medicine Centre, Melbourne, VIC, Australia.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220126
PL  - Netherlands
TA  - J Tradit Complement Med
JT  - Journal of traditional and complementary medicine
JID - 101605474
PMC - PMC9446108
OTO - NOTNLM
OT  - Adverse event
OT  - Chinese herbal medicine
OT  - Conventional disease-modifying anti-rheumatic drugs
OT  - Efficacy
OT  - Rheumatoid arthritis
COIS- The authors declare that they have no known competing financial interests or 
      personal relationships that could have appeared to influence the work reported in 
      this paper.
EDAT- 2022/09/10 06:00
MHDA- 2022/09/10 06:01
PMCR- 2022/01/26
CRDT- 2022/09/09 02:13
PHST- 2021/09/05 00:00 [received]
PHST- 2022/01/04 00:00 [revised]
PHST- 2022/01/22 00:00 [accepted]
PHST- 2022/09/09 02:13 [entrez]
PHST- 2022/09/10 06:00 [pubmed]
PHST- 2022/09/10 06:01 [medline]
PHST- 2022/01/26 00:00 [pmc-release]
AID - S2225-4110(22)00005-0 [pii]
AID - 10.1016/j.jtcme.2022.01.005 [doi]
PST - epublish
SO  - J Tradit Complement Med. 2022 Jan 26;12(5):437-446. doi: 
      10.1016/j.jtcme.2022.01.005. eCollection 2022 Sep.