A systemic review and meta-analysis of the clinical efficacy and safety of total glucosides of peony combined with methotrexate in rheumatoid arthritisReport as inadecuate




A systemic review and meta-analysis of the clinical efficacy and safety of total glucosides of peony combined with methotrexate in rheumatoid arthritis - Download this document for free, or read online. Document in PDF available to download.

Clinical Rheumatology

pp 1–8

First Online: 27 July 2017Received: 14 March 2017Revised: 08 July 2017Accepted: 18 July 2017

Abstract

To assess the efficacy and safety of the combination of total glucoside of peony TGP and methotrexate MTX for the treatment of rheumatoid arthritis RA. Randomized controlled trial RCT data on the traditional Chinese active component TGP combined with MTX vs. MTX alone for the treatment of RA was collected by searching the Pubmed, Embase, Cochrane Library, CNKI, VIP Journals database, and Wanfang database up to February 2017. Study selection, data extraction, data synthesis, and data analyses were performed according to the Cochrane standards. A total of eight RCTs involving 522 participants were included in this meta-analysis. Compared with MTX alone, the use of TGP combined with MTX exhibited better therapeutic effects for the treatment of RA P = 0.004. In addition, TGP combined with MTX caused a more significant decrease in erythrocyte sedimentation rate ESR P < 0.0001 and swollen joint count SJC P < 0.00001. However, no significant differences were found in C-reactive protein CRP P = 0.19, duration of morning stiffness DMS P = 0.32, or tender joint count TJC P = 0.23 between the two groups. In addition, adverse events were more frequently reported in the MTX monotherapy group than in the TGP and MTX combination group P = 0.0007. Our study demonstrates that TGP combined with MTX is more effective than MTX alone for the treatment of RA. Nevertheless, the adverse effects of the combination of TGP and MTX need to be further assessed. Due to the poor methodological quality of included trials, well-designed, multi-center, and large-scale RCTs are necessary to draw a more definitive conclusion.

KeywordsMeta-analysis Methotrexate Randomized controlled trial Rheumatoid arthritis Systematic review Total glucosides of peony Traditional Chinese medicine  Download fulltext PDF



Author: Zhi-tao Feng - Juan Xu - Guo-chao He - San-jin Cai - Juan Li - Zhi-gang Mei

Source: https://link.springer.com/







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