Abstract
Objective The safety and efficacy of Tripterygium glycosides (TG) were assessed for ankylosing spondylitis (AS) in accordance with the existing literatures. Materials and Methods Electronic literature was searched from Chinese VIP databases, Cochrane Library, Chinese Biomedical Literature Database, Wanfang Web of Science, EMBASE, Chinese National Knowledge Infrastructure, and the PubMed for the studies with the publication from the beginning to December 2021. Randomized controlled trials (RCTs) were included only. The major variables of result comprised erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Spinal Pain Visual Analog Score (SP-VAS), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Moreover, the secondary variables of result covered the overall clinical effective rate following the adverse drug reaction (ADR). We carried out the meta-analysis with the use of STATA 12.0 and RevMan 5.3. We used GRADE pro3.6.1 software to assess the quality of evidence. Results In general, we covered 15 randomized controlled trials with the focus of 1186 patients. As proven by our meta-analysis, TG as adjuvant therapy or monotherapy decreased the BASDAI, BASFI, SP-VAS, serum CRP, and ESR than control in patients suffering from AS. Additionally, TG treatment visibly improved the overall effective rate in AS. Nevertheless, TG was not found to significantly increase the rate of ADR in contrast to the control. Conclusion As indicated by our result, TG may be an option to treat AS. In this paper, we recommended strict trials with high quality and large samples sizes for confirming the finding here.
Highlights
Ankylosing spondylitis (AS) refers to a chronic disease that can cause inflammation
The pooled results illustrated that Tripterygium glycosides (TG) plus control had significance in terms of the reduction of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in contrast to the control (SMD = −1:578; 95%confidence interval (CI) = −1:940 to −1.216; P < 0:001, heterogeneity χ2 = 6:37, df = 3, I2 = 52:9%, P = 0:095, Figure 4(b))
Meta-regression was used for the exploration of heterogeneity sources
Summary
Ankylosing spondylitis (AS) refers to a chronic disease that can cause inflammation. AS can result in damage of structures and inflammation, mostly occurring within the spine or the sacroiliac joint, which normally leads to patients’ morning stiffness and chronic back pain and causes spinal immobility and ankylosis [1, 2]. It could lead to the rigid and completely fused spine. “Bamboo spine” is formed based on ossification within the fibrous ring’s external fibers of intervertebral discs, forming adjoining vertebra’s marginal syndesmophyte [3]. It frequently gives rise to extra-articular aggravation such as inflammatory bowel disease, psoriasis, and uveitis [4]. Young men with 20 to 30 years old are more prone to AS [5].
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