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The
use of TwHF along with MTX may prove to be useful for treating the RA patients.
For several decades, the extracts of Tripterigium wilfordii
Hook F or TwHF (a traditional Chinese herbal medicine) and methotrexate (MTX)
have been used for rheumatoid arthritis treatment in China. But, the efficacy and safety of MTX and TwHF
treatment is debatable.
A comprehensive search of databases in both Chinese and
English was executed. Two authors independently extracted and investigated data
from the selected studies.
A total of 643 patients participated in six randomized
controlled trials incorporated in the final analysis. TwHF (in the form of
Tripterygium glycosides) was added to the MTX-based therapy in all trials.
For efficacy, the addition of TwHF increased 50% responder
rates (RR) (RR 1.337, 95% confidence interval [CI]: 1.188-1.505, P<0.001),
and it lowered swollen and tender joint counts, shortened the duration of
morning stiffness, decreased the erythrocyte sedimentation rate, and decreased
the level of C-reactive protein and rheumatoid factor. For safety, the addition
of TwHF did not augement the rate of adverse events (RR 0.824, 95% CI: 0.635-1.068,
P=0.143).
Thus, we came to know that
MTX plus TwHF therapy may be a more effective and similar
safe strategy for RA management as compared to MTX monotherapy. Although,
further large clinical trials to investigate the TwHF add-on therapy are
permitted.
Life Sci.
Treatment of rheumatoid arthritis with combination of methotrexate and Tripterygium wilfordii: A meta-analysis
Wang X et al.
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