Systemic Review and Meta-Analysis of the Clinical Efficacy and Adverse Effects of Zhengqing Fengtongning Combined with Methotrexate in Rheumatoid Arthritis

Abstract

Chinese medicines are gaining wider acceptance. They have been used for treating rheumatoid arthritis (RA) for thousands of years, and the need to investigate the interaction between Chinese medicines and western medicines is widely recognized. In this study, a large number of RCTs and CCTs were analyzed to systematically assess the effects and adverse events of Zhengqing Fengtongning (ZQFTN) for RA. Eleven studies that contained 956 participants (508 in the treatment group; 448 in the control group) were included. The results showed that although ZQFTN combined with methotrexate MTX could not decrease the swollen joint count and tender joint count of RA patients better than MTX alone, the combination therapy might relieve the duration of morning stiffness (SMD: −16.06; 95% CI: −28.77 to −3.34), reduce laboratory indexes (RF: SMD: −10.84; 95% CI: −19.39 to −2.29; ESR: SMD: −7.26; 95% CI: −11.54 to −2.99; CRP: SMD: −3.66; 95% CI: −5.94 to −1.38), and improve the overall effect (RR: 1.08; CI: 1.01 to 1.16) better than monotherapy. The combination therapy was significantly better in controlling adverse drug reactions (RR: 0.60; 95% CI: 0.46 to 0.79). Through this systematic review, we found that ZQFTN combined with MTX for the treatment of RA might have better clinical efficacy than MTX only and might be superior in terms of controlling adverse drug reactions.

Polygonum multiflorum-Induced Liver Injury: Clinical Characteristics, Risk Factors, Material Basis, Action Mechanism and Current Challenges

“…Analysis of the clinical characteristics of patients with liver injury caused by PM and preparations showed that some patients taking normal or less than the normal doses of PM, and even some patients taking the drug only once in a relatively short period of time, developed liver damage. Several patients have a familial adverse reactions to liver organ damage (Liang et al, 2014;China, 2015;Cui et al, 2016;Cheng-Sheng and Sun, 2017). This is probably due to the presence of hereditary hepatic metabolic enzyme deficiency which in turn promotes the accumulation of toxic compounds in the process of biotransformation and metabolism, leading to PM-induced liver damage.…”

A gene catalogue of the Sprague-Dawley rat gut metagenome

“…MTX is a widely used disease-modifying, anti-rheumatic drug [ 22 ]. GJK is a Chinese experimental herb formula [ 23 ], and ZQFTN is a monomer drug derived from the Chinese traditional herb- Caulis Sinomenii [ 24 ]. These three drugs have been used in China for RA therapy for a long time with good effectiveness.…”

Agranulocytosis Induced by Sinomenine Hydrochloride

“…The alkaloid, sinomenine hydrochloride (7,8-didehydro-4-hydroxy-3,7-dimethoxy-17- methylmorphinane-6-one, C 19 H 23 NO 4 ), CAS number 6080-33-7, is extracted from the Chinese herbal medicinal plant, Sinomenium acutum , and has been widely used for centuries in China to treat patients with rheumatic diseases. Clinical side effects typically associated with sinomenine hydrochloride therapy include gastrointestinal symptoms, allergic responses, increased serum alanine transaminase (ALT), dizziness, and leukopenia [ 5 , 6 ]. This report is the first to describe a case of sinomenine hydrochloride-induced agranulocytosis.…”