BACKGROUND: Preparations of the herb Tripterygium wilfordii Hook F are used widely for the treatment of chronic kidney disease in China. The efficacy and safety of Tripterygium preparations still have not been fully identified. STUDY DESIGN: Systematic review and meta-analysis. SETTING & POPULATION: Patients with chronic kidney disease. SELECTION CRITERIA FOR STUDIES: Randomized controlled trials. INTERVENTION: Tripterygium preparations (Tripterygium glycoside tablets, Tripterygium hypoglaucum Hutch tablets, and Tripterygium granules or extracts) versus placebo, standard care, or other immunosuppressive treatment. OUTCOMES: Weighted mean difference and summary estimates of relative risk (RR) reductions with 95% CIs were calculated with a random-effects model. Outcomes analyzed included change in proteinuria, serum creatinine level, and creatinine clearance rate, as well as remission and relapse rate and drug-related adverse events. RESULTS: We identified 75 trials that included 4,386 participants. Overall, Tripterygium therapy reduced proteinuria by protein excretion of 628 (95% CI, -736 to -521) mg/d and reduced serum creatinine level by 0.12 (95% CI, -0.17 to -0.06) mg/dL compared with controls (both P < 0.001) in a range of kidney conditions. Tripterygium preparations also increased the rate of complete remission by 56% (95% CI, 32%-85%; P < 0.001) and of complete or partial remission by 24% (95% CI, 17%-31%; P < 0.001) while reducing relapse by 58% (95% CI, 42%-69%; P < 0.001). Tripterygium preparations increased the rate of liver function test result abnormalities (RR, 4.03; 95% CI, 2.24-7.25; P < 0.001) and altered menstruation (RR, 5.29; 95% CI, 2.09-13.38; P < 0.001). LIMITATIONS: Suboptimal study quality, significant heterogeneity in the primary outcome. CONCLUSIONS: Tripterygium preparations may have nephroprotective effects, but high-quality trials are required to reliably determine the balance of benefits and harms.
BACKGROUND: Preparations of the herb Tripterygium wilfordii Hook F are used widely for the treatment of chronic kidney disease in China. The efficacy and safety of Tripterygium preparations still have not been fully identified. STUDY DESIGN: Systematic review and meta-analysis. SETTING & POPULATION: Patients with chronic kidney disease. SELECTION CRITERIA FOR STUDIES: Randomized controlled trials. INTERVENTION: Tripterygium preparations (Tripterygiumglycoside tablets, Tripterygium hypoglaucum Hutch tablets, and Tripterygium granules or extracts) versus placebo, standard care, or other immunosuppressive treatment. OUTCOMES: Weighted mean difference and summary estimates of relative risk (RR) reductions with 95% CIs were calculated with a random-effects model. Outcomes analyzed included change in proteinuria, serum creatinine level, and creatinine clearance rate, as well as remission and relapse rate and drug-related adverse events. RESULTS: We identified 75 trials that included 4,386 participants. Overall, Tripterygium therapy reduced proteinuria by protein excretion of 628 (95% CI, -736 to -521) mg/d and reduced serum creatinine level by 0.12 (95% CI, -0.17 to -0.06) mg/dL compared with controls (both P < 0.001) in a range of kidney conditions. Tripterygium preparations also increased the rate of complete remission by 56% (95% CI, 32%-85%; P < 0.001) and of complete or partial remission by 24% (95% CI, 17%-31%; P < 0.001) while reducing relapse by 58% (95% CI, 42%-69%; P < 0.001). Tripterygium preparations increased the rate of liver function test result abnormalities (RR, 4.03; 95% CI, 2.24-7.25; P < 0.001) and altered menstruation (RR, 5.29; 95% CI, 2.09-13.38; P < 0.001). LIMITATIONS: Suboptimal study quality, significant heterogeneity in the primary outcome. CONCLUSIONS:Tripterygium preparations may have nephroprotective effects, but high-quality trials are required to reliably determine the balance of benefits and harms.
Keywords:
Chinese herbs; Tripterygium; chronic kidney disease; glomerular disease; kidney function; meta-analysis; proteinuria; systematic review; traditional Chinese medicine
Authors: Fainmarinat S Inabuy; Justin T Fischedick; Iris Lange; Michael Hartmann; Narayanan Srividya; Amber N Parrish; Meimei Xu; Reuben J Peters; B Markus Lange Journal: Plant Physiol Date: 2017-07-27 Impact factor: 8.340
Authors: Wei Wu; Rui Cheng; Hamza Boucetta; Lei Xu; Jing-Ru Pan; Min Song; Yu-Ting Lu; Tai-Jun Hang Journal: Front Pharmacol Date: 2022-06-09 Impact factor: 5.988