Predicting and verifying outcome of Tripterygium wilfordii Hook F. based therapy in rheumatoid arthritis: from open to double-blinded randomized trial

Abstract

Tripterygium wilfordii Hook F. (TwHF) based therapy has been proved as effective in treating rheumatoid arthritis (RA), yet the predictors to its response remains unclear. A two-stage trial was designed to identify and verify the baseline symptomatic predictors of this therapy. 167 patients with active RA were enrolled with a 24-week TwHF based therapy treatment and the symptomatic predictors were identified in an open trial; then in a randomized clinical trial (RCT) for verification, 218 RA patients were enrolled and classified into predictor positive (P+) and predictor negative (P−) group, and were randomly assigned to accept the TwHF based therapy and Methotrexate and Sulfasalazine combination therapy (M&S) for 24 weeks, respectively. Five predictors were identified (diuresis, excessive sweating, night sweats for positive; and yellow tongue-coating, thermalgia in the joints for negative). In the RCT, The ACR 20 responses were 82.61% in TwHF/P+ group, significantly higher than that in TwHF/P− group (P = 0.0001) and in M&S/P+ group (P < 0.05), but not higher than in M&S/P− group. Similar results were yielded in ACR 50 yet not in ACR 70 response. No significant differences were detected in safety profiles among groups. The identified predictors enable the TwHF based therapy more efficiently in treating RA subpopulations.

Ca2+ signalling plays a role in celastrol‐mediated suppression of synovial fibroblasts of rheumatoid arthritis patients and experimental arthritis in rats

“…Genes and pathways are colour-coded according to the upper part. RA pathogenesis factor colours are only linked to their coloured asterisks ( * ) and are independent of the gene and pathway colour-coding & Moudgil, 2011; Li et al, 2012;Nanjundaiah et al, 2012;Li et al, 2013;Astry et al, 2015;Jiang et al, 2015;Lv et al, 2015). Although the molecular targets responsible for the celastrol-mediated antiarthritic effect have been identified (Cascao et al, 2012;Li et al, 2012;Li et al, 2013;Astry et al, 2015;Cascao, Fonseca, & Moita, 2017 (Wang et al, 2016).…”

Complementary and alternative medicine for rheumatic diseases: A systematic review of randomized controlled trials

“…In a study looking at orally administered T. wilfordii based therapy 87 , RA patients were classified into predictor positive (P1) and predictor negative (P2) group, and were randomly assigned to accept the T.…”

Differential Amino Acid, Carbohydrate and Lipid Metabolism Perpetuations Involved in a Subtype of Rheumatoid Arthritis with Chinese Medicine Cold Pattern

“…Traditional Chinese Medicine (TCM) has been used in China for centuries and has shown efficacy in RA treatment [1]. According to TCM theory, pattern differentiation is one of the most important concepts in the practice of TCM, and the clinical efficacy would increase if right TCM pattern is chosen during the treatment process [2,3]. It consists of a series of diagnostic information including symptoms, tongue appearance and pulse feelings of patients [4].…”