Qin Chen
Tongde Hospital, China
Title: Meta-analysis of tripterygium for Henoch–Schönlein Purpura Nephritis
Biography
Biography: Qin Chen
Abstract
Background: Although tripterygium, a traditional Chinese herbal medicine used as an immunosuppressive agent, has been prescribed in China for patients with Henoch–Schönlein Purpura Nephritis (HSPN), its efficacy and safety have not yet been fully identified.
Study Design: Systematic review and meta-analysis.
Setting and Population: Patients with Henoch–Schönlein Purpura Nephritis (HSPN).
Selection Criteria for Studies: Randomized controlled trials and quasi-randomized controlled trials.
Intervention: Routine therapy was given in experimental and control group, which included the usage of anti-histamine drugs, anti-infective agents etc. Experimental group was tripterygium or the combination of tripterygium and glucocorticoid; control group was routine therapy or the combination of routine therapy and glucocorticoid.
Outcomes: Primary outcomes included remission and the regression time of hematuria, proteinuria and edema; secondary outcomes included the regression time of pupura, serum creatinine, 24 hour proteinuria, relapse and drug-related adverse events.
Results: 31 trials enrolling 2030 patients were included. Tripterygium exclusive use could significantly increase complete remission (RR 1.71, 95% CI 1.16 to 2.52) and shorten the regression time of purpura (MD -3.20, 95% CI -4.69 to -1.71). Compared with glucocorticoid, the combination of Tripterygium and glucocorticoid could significantly increase complete remission (RR 1.39, 95% CI 1.24 to 1.56) and over-all remission (RR 1.24, 95% CI 1.18 to 1.31) with lower risk of relapse (RR 0.29, 95% CI 0.16 to 0.55); the regression time of hematuria (MD -11.71, 95% CI -13.76 to -9.66), proteinuria (MD -8.11, 95% CI -9.74 to -6.49) and edema (MD -3.48, 95% CI -4.58 to -2.39) were shortened as well, with an increase in adverse events at the same time.
Limitations: Suboptimal study quality.
Conclusions: The present meta-analysis suggested that tripterygium use could relieve clinical symptoms of HSPN to some extent. At the same time, the results suggested that tripterygium was relatively safe in incidence of dysfunction of liver, gastrointestinal discomfort and leucopenia.