Clinical efficacy and safety of Tripterygium wilfordii Hook in the treatment of diabetic kidney disease stage IV

Ren, Daijin; Zuo, Chao; Xu, Gaosi

doi:10.1097/md.0000000000014604

Cited by 20 publications

(20 citation statements)

References 17 publications

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“…In our present meta-analysis, 26 clinical studies including 1824 subjects (939 in experiment group and 885 in control group) were included. we found the TGs groups howed signi cant effects in reducing 24-UTP (P < 0.05), elevating Alb (P < 0.05), reducing Scr (P < 0.05), elevating Ccr (P < 0.05), and increasing the total e ciency, when compared to the control group, which is the same as others meta-analysis [11,45,46] . However, TGs treatment had no obvious advantage in improving BUN (P > 0.05) and increasing ALT (P > 0.05), The adverse effects of bone marrow suppression is obvious in TGs group, there was signi cant effect in reducing WBC (P < 0.05), when compared to the control group.…”

Section: Discussionsupporting

confidence: 85%

Efficacy of Tripterygium Glycosides for Diabetic Nephropathy: A Meta-Analysis of Randomized Controlled Trials

Guo

Jie

Zhang

et al. 2021

Preprint

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Backgrounds: Diabetic nephropathy (DN) is one of the most important clinical complications of diabetes mellitus (DM) and is the most common cause of end-stage renal disease. Currently, there is no highly effective medicine that can prevent, halt, or reverse the progressive course of DN. Initial clinical data showed that Tripterygium glycosides (TGs), a traditional Chinese medicine, can decrease proteinuria in patients with DN.Objectives: The objective of the present study is to investigate the efficacy and safety of TGs for the treatment of DN by meta-analysis of randomized controlled trials (RCTs). Methods: All RCTs of TGs for DN were collected from The China National Knowledge Infrastructure (CNKI), Web of Science, Wanfang Data, Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (VIP ) by setting the study inclusion and elimination standards. Two reviewers evaluated the quality of the trials and extracted the data independently. RevMan 5.4 software was used for meta-analyses. The primary outcome was a change in 24-hours urinary total protein (24h TUP). Results: 26 RCTs with 1824 participants were collected for detailed evaluation. The meta-analysis results indicated that TGs was compared with the controls, TGs showed signiﬁcant effects in reducing 24h TUP [WMD = -0.84, 95%CI (-1.09, -0.59)], elevating serum albumin [WMD = 2.88, 95% CI (1.87, 3.90)], and the total efﬁciency [OR =4.08, 95% CI (2.37, 7.04)]. This effect was consistent across the subgroups of period of intervention. Conclusions: The present research showed that TGs was significantly associated with improvement of renal function in patients with DN. TGs offers a novel way in treating DN, more high quality RCTs are needed for better understanding of the role of TGs in DN therapy.

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Section: Discussionsupporting

confidence: 85%

Efficacy of Tripterygium Glycosides for Diabetic Nephropathy: A Meta-Analysis of Randomized Controlled Trials

Guo

Jie

Zhang

et al. 2021

Preprint

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“…A meta-analysis of RCTs carried out in patients with stage 4 diabetic CKD showed that TwHF combined with an ARB was more effective than an ARB alone when considering 24 h proteinuria and serum albumin, but with an increase in AE frequency of 8% [32]. A recent review indicated that TwHF-based therapies for CKD in mainland China were more effective in improving proteinuria, blood creatinine levels, and blood urea nitrogen levels than conventional Western medicine alone or other immunosuppressive regimens [33].…”

Section: Discussionmentioning

confidence: 99%

Tripterygium wilfordii Hook F Treatment for Stage IV Diabetic Nephropathy: Protocol for a Prospective, Randomized Controlled Trial

Bán

Wang

et al. 2020

BioMed Research International

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Background. Diabetic nephropathy (DN) is a major cause of chronic kidney disease (CKD). There are no effective treatments to prevent or reverse the progression of DN. A preliminary study showed that Tripterygium glycosides from Tripterygium wilfordii Hook F (TwHF) with valsartan decrease proteinuria in patients with DN. Objectives. The objective of the present study is to investigate the efficacy and safety of Tripterygium glycosides from TwHF, a traditional Chinese medicine, for the treatment of DN. Methods and Analysis. This is a prospective, single-center randomized controlled trial. Seventy participants diagnosed with DN were recruited and randomized 1 : 1 to two groups: (1) angiotensin receptor blocker (ARB) combined with TwHF and (2) ARB-only. The treatment period is 48 weeks. The primary endpoint is 24 h proteinuria decreased level (reduction of 30% vs. baseline) after 48 weeks of treatment. The secondary endpoints are (1) all-cause and cardiovascular-related mortality, (2) development of ESRD (serum creatinine>530.4 μmol/L or estimated glomerular filtration rate eGFR<15 mL/min/1.73 m2), (3) the need for renal replacement therapy, and (4) increased serum creatinine (2-fold higher than the baseline value or ≥442 μmol/L, with confirmation of the initial results after 4 weeks). A health economics analysis will be carried out. Discussion. A meta-analysis of RCTs carried out in patients with stage 4 (Mogensen classification) diabetic CKD showed that TwHF combined with an ARB was more effective than an ARB alone when considering 24 h proteinuria and serum albumin, but with an increase in adverse event (AE) frequency of 8%. This is a prospective clinical trial that may provide information on a safe and effective novel method for the treatment of DN, especially for patients with macroproteinuria. Ethics and Dissemination. The protocol is approved by the ethics committee of Beijing Hospital (2016BJYYEC-059-02). The results will be disseminated through peer-reviewed publications and international conferences. This trial is registered with ChiCTR-IOR-17010623.

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“…Tripterygium glycoside, an extract from a natural herb Tripterygium Hook. f. with strong immunosuppressive and anti-inflammatory effects, has been reported to decrease proteinuria and improve renal dysfunction in DKD through numerous randomized controlled clinical trials [45, 63]. In high-glucose serum from db/db mouse induced podocytes, tripterygium glycoside intervention significantly decreased apoptotic activity, along with elevated LC3-II/LC3-I ratios and reduced expression of p62 [18].…”

Section: Mechanisms Of Chinese Herbal Medicine Treating Dkd Via Acmentioning

confidence: 99%

Chinese Herbal Medicine in Ameliorating Diabetic Kidney Disease via Activating Autophagy

Wang

Zhao

Wang

et al. 2019

Journal of Diabetes Research

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Diabetic kidney disease (DKD), a leading cause of end-stage renal disease (ESRD), has become a serious public health problem worldwide and lacks effective therapies due to its complex pathogenesis. Recent studies suggested defective autophagy involved in the pathogenesis and progression of DKD. Chinese herbal medicine, as an emerging option for the treatment of DKD, could improve diabetic kidney injury by activating autophagy. In this review, we briefly summarize underlying mechanisms of autophagy dysregulation in DKD, including AMP-activated protein kinase (AMPK), the mechanistic target of rapamycin (mTOR), and the sirtuin (Sirt) pathways, and we particularly concentrate on the current status of Chinese herbal medicine treating DKD by regulating autophagy. The advances in our understanding regarding the treatment of DKD via regulating autophagy with Chinese herbal medicine will enhance the clinical application of Chinese medicine as well as discovery of novel therapeutic agents for diabetic patients.

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Clinical efficacy and safety of Tripterygium wilfordii Hook in the treatment of diabetic kidney disease stage IV

Abstract: Supplemental Digital Content is available in the text

Cited by 20 publications

References 17 publications

Efficacy of Tripterygium Glycosides for Diabetic Nephropathy: A Meta-Analysis of Randomized Controlled Trials

Efficacy of Tripterygium Glycosides for Diabetic Nephropathy: A Meta-Analysis of Randomized Controlled Trials

Tripterygium wilfordii Hook F Treatment for Stage IV Diabetic Nephropathy: Protocol for a Prospective, Randomized Controlled Trial

Chinese Herbal Medicine in Ameliorating Diabetic Kidney Disease via Activating Autophagy

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