Traditional Chinese medicine use is associated with lower risk of pneumonia in patients with systemic lupus erythematosus: a population-based retrospective cohort study

Abstract

Objectives: To investigate the association between traditional Chinese medicine (TCM) therapy and the risk of pneumonia in patients with systemic lupus erythematosus (SLE).Methods: This population-based control study analyzed the data retrieved from the National Health Insurance Research database in Taiwan. From a cohort of 2 million records of the 2000–2018 period, 9,714 newly diagnosed patients with SLE were initially included. 532 patients with pneumonia and 532 patients without pneumonia were matched 1:1 based on age, sex, and year of SLE diagnosis using propensity score matching. The use of TCM therapy was considered from the SLE diagnosis date to the index date and the cumulative days of TCM therapy were used to calculate the dose effect. Conditional logistic regression was used to investigate the risk of pneumonia infection. Furthermore, to explore the severity of pneumonia in SLE, sensitivity analyses were performed after stratification using the parameters of emergency room visit, admission time, and antibiotic use.Results: TCM therapy for >60 days could significantly reduce the risk of pneumonia in patients with SLE (95% CI = 0.46–0.91; p = 0.012). Stratified analysis showed that TCM use also reduced the risk of pneumonia in younger and female patients with SLE by 34% and 35%, respectively. TCM for >60 days significantly reduced the risk of pneumonia in the follow-up periods of >2, >3, >7, and >8 years. In addition, the exposure of TCM for >60 days reduced the risk of pneumonia in patients with SLE who were treated with antibiotics for moderate or severe pneumonia. Finally, the study found that using formulae to tonify the kidney for more than 90 days and formulae to activate blood circulation for less than 30 days could significantly reduce the risk of pneumonia infection in patients with SLE.Conclusion: TCM use is associated with a lower risk of pneumonia among patients with SLE.

Renal and survival benefits of seventeen prescribed Chinese herbal medicines against oxidative-inflammatory stress in systemic lupus erythematosus patients with chronic kidney disease: a real-world longitudinal study

“…In line with previous research (Ma et al, 2016;Chen et al, 2022;Chen et al, 2023;Ma et al, 2023), our findings indicated that patients receiving the 17 PRCHMSLE may experience a reduction in all-cause mortality, a lower incidence of ESRD, fewer hospital admissions, and no potential for an increase in the risk of hyperkalemia. We also identified a lower risk of noncardiovascular mortality in patients with SLE-CKD using PRCHMSLE compared to nonusers, mirroring findings from a previous NHI-based cohort study that indicated a reduced risk of pneumonia in patients with SLE using CHMs compared to nonusers (Wang et al, 2023). However, our results did not demonstrate a significant reduction in the risk of Frontiers in Pharmacology frontiersin.org cardiovascular mortality in patients with SLE-CKD using PRCHMSLE.…”

“…Notably, the top five treatments offering the most renal protection were Gan-Lu-Ying, Anemarrhena asphodeloides Bunge [Asparagaceae; Rhizoma Anemarrhenae] (Zhi-Mu), Rehmannia SLE is a complex disease affecting multiple bodily systems, including renal, cardiovascular, and pulmonary functions (Vymetal et al, 2016). Recent cohort studies using Taiwan's NHI claims data have spotlighted potential benefits of CHMs in SLE management, indicating decreased risks of LN (Chang et al, 2017), mortality (Ma et al, 2016), cardiovascular disease (Yu and Hsieh, 2021), pneumonia (Wang et al, 2023), and hospitalization (Ma et al, 2023). Significantly, LN is a chief factor in SLE-related deaths (Sciascia et al, 2017).…”