Abstract
Objective To carry out the meta-analysis on the clinical safety of glycyrrhizic acid and the influencing factors between 18α-glycyrrhizinate (18α-GL) and 18β-glycyrrhizinate (18β-GL). Methods Magnesium isoglycyrrhizinate injection was used as the representative preparation of 18α-GL, and compound glycyrrhizin injection was used as the representative preparation of 18β-GL. The clinical control trial of magnesium isoglycyrrhizinate injection and compound glycyrrhizin injection was searched in a computer, which was published from January 2006 to December 2019 on the databases such as PubMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (CSTJ), and Wanfang Medical Network (Wanfang Data). The data associated with adverse drug reactions (ADRs) were extracted. RevMan5.3 was used for statistical analysis. Results Finally, 24 studies were included, and 2757 patients were involved, of which the experimental group was mainly treated with magnesium isoglycyrrhizinate, while the control group was mainly treated with compound glycyrrhizin. The results showed that the occurrence of ADRs was significantly lower in the experimental group than that in the control group, and the difference between two groups was statistically significant (RR = 0.26, 95% CI = (0.18, 0.38), P < 0.00001). There was no heterogeneity among the studies (I2 = 0%, P=1.00). Conclusion Compared with 18β-GL, 18α-GL had a lower incidence of adverse reactions and better clinical safety.
Highlights
Glycyrrhizin (GL) is one of the active ingredients in licorice, and it has been widely used in clinical diseases of abnormal liver function
Existing studies with small samples have shown that magnesium isoglycyrrhizinate (MI) and compound glycyrrhizin (CG) have differing conclusions of the adverse drug reactions (ADRs)
The results showed that the relative risk (RR) of ADR development in the MI group was significantly lower than that in the CG group (RR 0.26, 95% confidence interval (CI) (0.18, 0.38), P < 0.00001)
Summary
Glycyrrhizin (GL) is one of the active ingredients in licorice, and it has been widely used in clinical diseases of abnormal liver function. GL is classified into 18α-glycyrrhizinate (18α-GL) and 18βglycyrrhizinate (18β-GL) [1]. The difference between the efficacy and safety of these two epimers has become the focus of clinical attention. 18α-GL drug on the market is magnesium isoglycyrrhizinate (MI), and the representative 18β-GL drug is compound glycyrrhizin (CG). Existing studies with small samples have shown that MI and CG have differing conclusions of the adverse drug reactions (ADRs). The studies of Ye et al [2] and Mao et al [3] showed that there were no differences in ADRs between these two drugs
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