The Derivative of Tripterygium wilfordii Hook F-Kunxian Capsule, Attenuated Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.

Ya-Fei Liu,Zhe Zhang,Sheng-Hao Tu,Zhe Chen,Guo-Lan Xing,Jun-Jun Zhang

doi:10.1155/2020/4178140

Abstract

The study aimed to explore the efficacy and safety of Kunxian Capsule (KXC) in the treatment of rheumatoid arthritis (RA). The randomized controlled trials (RCTs) comparing the effects of KXC in patients with RA were included in this study. Weighted mean differences (MDs) were calculated for net changes by employing Review Manager meta-analysis software. Nine RCTs were included in the systematic review with a total of 747 patients. The overall effects showed that KXC alone or combined with disease-modifying antirheumatic and drugs decreased tender joint counts (P=0.02, MD = −1.07, 95% CI: −1.95 to −0.18), shortened duration of morning stiffness (P < 0.0001, MD = −9.01, 95% CI: −13.08 to −4.93), lowered erythrocyte sedimentation rate (P < 0.00001, MD = −5.27, 95% CI: −6.78 to −3.77), and reduced C-reactive protein (P < 0.0001, MD = −5.04, 95% CI: −7.28 to −2.80). The most common adverse events were gastrointestinal disturbances and abnormal liver function. These results suggest that KXC is likely to be a more effective and safe candidate for treating RA compared with conventional therapies.

Highlights

Rheumatoid arthritis (RA) is an autoimmune disease inducing synovial inflammation, which is characterized by tenderness, swelling, morning stiffness, joint destruction, and deformity [1, 2]. e age-standardized prevalence and incidence rates are increasing, especially in countries such as Canada, Paraguay, and Guatemala
Tripterygium wilfordii Hook F (TWHF) has been applied in the treatment of RA in China for decades [9]. e previous research showed that TWHF could be as effective as synthetic diseasemodifying antirheumatic and drugs (DMARDs) in the treatment of RA and the common adverse effects (AEs) were gastrointestinal discomfort, menstruation disorders, and amenorrhea [10]
According to the selection criteria defined in the Materials and Methods, 9 randomized controlled trials (RCTs) were included in the meta-analysis. e three-armed group design was applied in two of the studies

Summary

Introduction

Rheumatoid arthritis (RA) is an autoimmune disease inducing synovial inflammation, which is characterized by tenderness, swelling, morning stiffness, joint destruction, and deformity [1, 2]. e age-standardized prevalence and incidence rates are increasing, especially in countries such as Canada, Paraguay, and Guatemala. Owing to the adverse effects of conventional medications and high financial stress of biologicals [8], more effective and safe medications for RA are needed to be explored. E previous research showed that TWHF could be as effective as synthetic DMARDs in the treatment of RA and the common adverse effects (AEs) were gastrointestinal discomfort, menstruation disorders, and amenorrhea [10]. KXC has been employed in treating RA in clinical trials for a long time [12,13,14]. Most of these clinical data origins from uncontrolled clinical trials or retrospective reports, and few multicenter clinical trials have been performed to verify the effects of KXC in the treatment

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Discussion

Conclusion