Efficacy of tripterygium glycosides combined with ARB on diabetic nephropathy: a meta-analysis

Wu, Xuemei; Huang, Youye; Zhang, Yao; He, Chunling; Zhao, Yongli; Wang, Lizhuo; Gao, Jialin

doi:10.1042/bsr20202391

Cited by 20 publications

(19 citation statements)

References 13 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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Section: Tripterygium Wilfordii and Its Components: Triptolide Tripterygium Glycosidesmentioning

confidence: 99%

“…Two meta-analyses ( Ren, et al, 2019 ; Wu, et al, 2020a ) evaluated the clinical efficacy and safety of Tripterygium wilfordii/tripterygium glycosides combined with ARB/ACEI in the treatment of stage IV DKD. In the controlled trial (RCT), 1414 participants ( Ren, et al, 2019 ) were evaluated in detail, and another meta-analysis included 23 studies, including a total of 1810 DN patients ( Wu, et al, 2020a ). Tripterygium wilfordii/tripterygium glycosides combined with ARB/ACEI significantly improved 24-h urinary total protein (24 h-UTP), urinary UAER, SCr, and albumin more than did ARB/ARB alone.…”

Section: Tripterygium Wilfordii and Its Components: Triptolide Tripterygium Glycosidesmentioning

confidence: 99%

New Insights Into the Effects of Individual Chinese Herbal Medicines on Chronic Kidney Disease

Shao

Bayliss

et al. 2021

Front. Pharmacol.

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The clinical and experimental study into the effects of Chinese herbal medicines on chronic kidney disease has evolved over the past 40 years with new insight into their mechanism and evidence of their clinical effects. Among the many traditional Chinese herbs examined in chronic renal disease, five were found to have evidence of sufficient clinical efficacy, high frequency of use, and well-studied mechanism. They are: Abelmoschus manihot and Huangkui capsule, Salvia miltiorrhiza and its components (tanshinone II A, salvianolic acid A and B); Rhizoma coptidis and its monomer berberine; Tripterygium wilfordii and its components (triptolide, tripterygium glycosides); Kudzu root Pueraria and its monomer Puerarin. These Chinese herbal medications have pharmaceutical effects against fibrosis, inflammation and oxidative stress and also promote renal repair and regeneration. This article reviews their clinical efficacy, anti-fibrotic effects in animal models, and molecular mechanism of action.

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“…Controversies exist between systematic reviews that focus on the clinical efficacy and adverse reactions of TG in the treatment of DN. Some researchers believe that TG can improve some clinical indicators of patients with DN, such as 24 h-UTP and serum creatinine level (24)(25)(26), while others reached negative conclusions that TG can significantly induce adverse reactions in patients with DN (27,28), and even questioned whether TG can be used to reduce the serum creatinine level of patients (28).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Tripterygium Glycoside in the Treatment of Diabetic Nephropathy: A Systematic Review and Meta-Analysis Based on the Duration of Medication

Miao

Liu

et al. 2021

Front. Endocrinol.

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AimThe aim of this study was to assess the clinical efficacy and safety of Tripterygium-derived glycosides (TG) after 3-month and 6-month of treatments of diabetic nephropathy (DN) and to resolve the conflict between medicine guidance and clinical practice for TG application.MethodsWe conducted a systematic review and meta-analysis of randomized controlled trials involving TG application in treating DN. We extensively searched PubMed, Cochrane Library, CNKI, VIP, Wan-Fang, CBM, Chinese Clinical Trial Registry, and WHO International Clinical Trial Registration Platform till November 2020, along with grey literature for diabetes and all other relevant publications to gather eligible studies. Based on the preset inclusion and exclusion criteria, document screening, quality assessment of methodology, and data extraction was conducted by two researchers independently. The methodological quality was assessed by the Cochrane risk test from the Cochrane Handbook 5.2, and then analyses were performed by Review Manager 5.3 (Rev Man 5.3). The quality of output evidence was classified by GRADE.ResultsThirty-one eligible studies (2764 patients) were included for this meta-analysis. Our study results showed a comparable significant decrease in the 24 h-UTP and blood creatinine levels in DN patients from both 3-month and 6-month TG treatment groups, compared with the routine symptomatic treatment alone. To the contrary of the findings from the included studies, our results showed that the occurrence of serious adverse reaction events was significantly higher in the TG treated group with 6 months of treatment duration compared to that of 3 months of the treatment course. However, the total AR ratio was slightly varied while increasing the percent of severe adverse events. GRADE assessment indicated that the quality of evidence investigating TG-induced adverse reactions was moderate and that for 24 h-UTP and blood creatinine indicators were considerably low.ConclusionCombinatorial treatment regimen including TG can significantly decrease the pathological indicators for DN progression, while it can also simultaneously predispose the patient to a higher risk for developing severe adverse events, as the medicine guidance indicates. Notably, even in 3-month of course duration smaller percent of severe adverse events can get to a fatal high percent and is likely to increase proportionally as the TG treatment continues. This suggests that TG-mediated DN treatment duration should be optimized to even less than 3 continuous months to avoid adverse event onset-associated further medical complications in DN patients. In clinical practice, serious attention should be paid to these severe side-effects even in a course normally considered safe, and importantly more high-quality studies are urgently warranted to obtain detailed insights into the balance between the efficacy and safety profiles of TG application in treating DN.

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Efficacy of tripterygium glycosides combined with ARB on diabetic nephropathy: a meta-analysis

Cited by 20 publications

References 13 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

New Insights Into the Effects of Individual Chinese Herbal Medicines on Chronic Kidney Disease

Efficacy and Safety of Tripterygium Glycoside in the Treatment of Diabetic Nephropathy: A Systematic Review and Meta-Analysis Based on the Duration of Medication

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