Review question / Objective: Regardless of pharmacological effects of Duantengyimutang (DTYMT)'s component, there is also concern about the safety. Therefore, this systematic review (SR) will focus on the effectiveness and safety of DTYMT on rheumatoid arthritis (RA). Rationale: As the treatment type by taking medication, several decoctions have been reported its effectiveness and safety, and recent study introduced DTYMT. Condition being studied: DTYMT is consisted of three main components (Phlomis umbrosa, Leonurine herba, and Tripterygium hypoglaucum Hutch), and several experimental studies have reported INPLASY 1 International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY PROTOCOLThe effectiveness and safety of Duantengyimu-tang for rheumatoid arthritis: A protocol for systematic review and meta-analysis Park, GE 1 ; Moon, JH 2 ; Kim, EJ 3 ; Sung, WS 4 .To cite: Park et al. The effectiveness and safety of Duantengyimu-tang for rheumatoid arthritis: A protocol for systematic review and meta-analysis. Inplasy protocol 202340100.

Background: Per-oral pharmacological medication is a representative treatment for rheumatoid arthritis (RA), and has improved over several guidelines. However, limitations of long-term use of these medications including adverse events, led to the introduction and utilization of complementary and alternative treatments for RA. Several herbal medicine decoctions have been reported to be effective and safe; a recent study introduced Duantengyimu-tang (DTYMT). Regardless of the pharmacological effects of the DTYMT components, there are concerns about its safety. Therefore, this systematic review (SR) will focus on the effectiveness and safety of DTYMT treatment for RA.Methods: Searches for randomized controlled trials using DTYMT treatment for RA will be performed using multiple electronic databases, manual searches, and emails (if necessary). A summary will be written using data on outcome measurements of the study participants, interventions, adverse events, and risk of bias in the studies. The primary outcomes will be disease activity scores including effective rate, tender joints, swollen joints, and morning stiffness. The secondary outcomes will include adverse events and blood tests for RA (erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factors). This SR will use Review Manager software to perform a meta-analysis, the Cochrane Collaboration “risk of bias” tool, and determine the quality of evidence using the Grades of Recommendation, Assessment, Development, and Evaluation method.Results: This SR will investigate the clinical effectiveness and safety of DTYMT treatment in patients with RA.Conclusion: This SR aims to be informative for patients and clinicians in clinical practice, researchers, and policymakers in managing RA.