The Effect of Chinese Medicine Compound in the Treatment of Rheumatoid Arthritis on the Level of Rheumatoid Factor and Anti-Cyclic Citrullinated Peptide Antibodies: A Systematic Review and Meta-Analysis

Abstract

Objectives: To evaluate the current evidence whether Chinese medicine compound (CMC) can reduce the serum levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (anti-CCP).Methods: We comprehensively searched PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), the Database for Chinese Technical Periodicals (VIP), and Wanfang data. We then performed a systematic review and meta-analysis of all randomized controlled trials (RCTs) assessing the CMC therapy methods. This study is registered with PROSPERO, number CRD42020216284.Results: In total, 65 studies were eligible for inclusion, including 6099 patients. The result of the meta-analysis showed that compared with common Western medicine therapy, CMC monotherapy or combined with Western medicine was able to reduce serum RF (SMD= −0.85, 95%CI −1.04 to −0.67) and anti-CCP (SMD= −0.56, 95%CI −0.79 to −0.32) levels to some extent. In the efficacy meta-analysis, a greater number of CMC-treated patients achieved the efficacy criteria after a period of treatment, where the relative risk (RR) was 1.20 [1.08, 1.33] for achieving ACR20, 1.57 [1.38, 1.78] for ACR50, and 2.21 [1.72, 2.84] for ACR70. At the same time, there was a statistically significant difference in the effective rate of the patient's TCM symptoms (RR = 1.22, 95%CI 1.19–1.26).Conclusions: Through this meta-analysis and systematic review, we found that CMC for the treatment of RA is effective in reducing RF and anti-CCP levels and might have better clinical efficacy than Western medicine monotherapy. Some active components are responsible for this efficacy and worth further exploring.

A chinese medicine formula (kunbixiao granule) for female rheumatoid arthritis: Study protocol for a double-blind, randomized, placebo-controlled trial

“…A recent epidemiologic study showed RA affected about 1% of the world's population (McInnes and Schett, 2017). The morbidity of RA is highest at the age of 50, with female patients as the main population (van der Woude and van der Helm-van Mil, 2018). Women are three to four times more prone to develop the disease than men, with data demonstrating a progressive increase in the incidence of RA in females during the last decade (Myasoedova et al, 2020).…”

“…Traditional Chinese Medicine (TCM) has shown advantages in the treatment of RA. Chinese medicine formula monotherapy or combined with Western medicine had better performance on improving clinical symptoms, preventing the disease progression, reducing serum rheumatoid factor and anti-cyclic citrullinated peptide antibodies, and improving the bone mineral density of RA than Western medicine monotherapy ( Cai, et al, 2018 ; Tang, et al, 2021 ; Zhang et al, 2022 ). But to date, there is no TCM clinical trial for RA in women.…”

Traditionelle chinesische Medizin – Relevant für die Behandlung der rheumatoiden Arthritis?

“…Ein im Jahr zuvor publizierte Metaanalyse und Review, in der 65 chinesische Studien mit insgesamt 6099 Patienten eingeschlossen waren, gibt Hinweise darauf, dass die Kombination der chinesischen Phytotherapie mit der klassischen antirheumatischen Therapie bei RA-Patienten effektiver hinsichtlich der Senkung des Serumspiegels des Rheumafaktors (RF) und des Anti-CCP-Antikörpers sei als die Monotherapie mit westlicher Medizin. Ein Publikationsbias kann verantwortlich sein, da nur Studien mit positiven Ergebnissen zur chinesischen Phytotherapie eingeschlossen waren [32].…”

Where traditional Chinese medicine meets Western medicine in the prevention of rheumatoid arthritis

“…However, there are a limited number of clinical trials and thus the evidence is low. The previous meta‐analysis demonstrated that TCM may target the immune system and help alleviate RA through different mechanisms—for instance, to lower the levels of both RF and anti‐cyclic citrullinated peptides (anti‐CCP) [81], to help protect the bones and cartilages and reduce damages [82] and to decrease the disease activity [83]. As outlined, treating the disease is not the only goal.…”