The role of Chinese herbal medicine in the management of adverse drug reactions of leflunomide in treating rheumatoid arthritis

Wang, Wanying; Zhou, Hua; Liu, Liang

doi:10.1016/j.phymed.2019.153136

Cited by 17 publications

(14 citation statements)

References 125 publications

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“…Depending on their symptoms, patients may be classified according to various patterns and treated by different approaches. The use of Chinese herbal medicine in the treatment of the syndrome could alleviate RA symptoms and attenuate side effects caused by chemical drugs [ 20 , 21 ]. The Chinese herbal medicine administered for RA treatment in our hospital is divided into four categories and can significantly improve RA immunity and inflammation indicators.…”

Section: Discussionmentioning

confidence: 99%

Identifying Compound Effect of Drugs on Rheumatoid Arthritis Treatment Based on the Association Rule and a Random Walking-Based Model

Fang

Liu

Xin

et al. 2020

BioMed Research International

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Rheumatoid arthritis (RA) is a chronic autoimmune disorder that is diagnosed mainly on the basis of patient signs, symptoms, and laboratory indices. However, the exact causes of RA are unclear. Moreover, there is a lack of any method of dynamically evaluating the efficacy of the medication administered to treat RA. Here, we applied a random walk model to reveal the compatibility among the various constituents of traditional Chinese medicine and evaluate their therapeutic efficacy against RA. Drugs commonly used to treat RA were investigated using cluster analysis. The association rule analysis was applied to identify compatibilities among the constituents. A random walk model was developed to evaluate drug efficacy based on an in-house database comprising the clinical records of 9,408 RA patients. Frequently administered medicines were combined into three correlated sets. The evaluation based on the random walk method showed that the drug combination improved ESR, CRP, C3, C4, and IgA more effectively than any single drug. The present study demonstrated that the TCM constituents complement each other and various combinations of them produce different therapeutic effects on RA treatment.

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Section: Discussionmentioning

confidence: 99%

Identifying Compound Effect of Drugs on Rheumatoid Arthritis Treatment Based on the Association Rule and a Random Walking-Based Model

Fang

Liu

Xin

et al. 2020

BioMed Research International

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“…In recent years, using the well-defined biochemical and pharmacological inhibitors to suppress rheumatoid arthritis in experimental animal models have been reported many times (Croia et al, 2019). Interestingly, studies find that many of these enzymes, derivatives and related signaling pathways can be targeted and intervened by several medicinal products, for instance, herbal medicinal products which belong to the traditional medicine or complementary and alternative medicine (Mateen et al, 2016;Wang et al, 2020). Therefore, this review article summarizes the roles of main enzymes and their derivatives of inflammation during the occurrence and pathogenesis of RA, to provide insight into how the herbal medicinal products that target these enzymes and their derivatives may lead to the prevention of RA.…”

Section: Introductionmentioning

confidence: 99%

Research Progress of Therapeutic Enzymes and Their Derivatives: Based on Herbal Medicinal Products in Rheumatoid Arthritis

Cai

Han

et al. 2021

Front. Pharmacol.

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Rheumatoid arthritis (RA) acts as one of the most common, agnogenic and chronic inflammatory-autoimmune disorder which is characterized by persistent synovitis, cartilage destruction, and joint deformities, leads to a wide range of disabilities, and increased mortality, thus imposing enormous burdens. Several drugs with anti-inflammatory and immunomodulatory properties such as celecoxib, diclofenac and methotrexate are being selected as conventional drugs in the allopathic system of medicine for the treatment of RA in clinic. However, there are some serious side effects more or less when using these drugs because of their short poor bioavailability and biological half-life for a long time. These shortcomings greatly promote the exploration and application of new low- or no-toxicity drugs for treating the RA. Meanwhile, a growing number of studies demonstrate that several herbs present certain anti-inflammatory and anti-arthritic activities through different enzymes and their derivatives, which indicate that they are promising therapeutic strategies when targeting these mediators based on herbal medicinal products in RA research. This review article summarizes the roles of the main enzymes and their derivatives during the pathogenesis of RA, and clearly clarifies the explicit and potential targeted actions of herbal medicinal products that have anti-RA activity. Our review provides timely and critical reference for the scientific rationale use of herbal medicinal products, with the increasing basic research and clinical application of herbal medicinal products by patients with RA.

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“…Through the TCM systems pharmacology (TCMSP) database (http://tcmspw.com/tcmsp.php), we searched for the related components of CHF following oral absorbability (OB) ≥30% and drug-likeness (DL) ≥0. 18 Secondly, the target proteins of compounds obtained from the TCMSP database were passed through the UniProt database (https://uniprot.org/) to be standardized. The Genecards database (https://www.genecards.org/) and the Online Mendelian Inheritance in Man (OMIM) database (https://omim.org/) were used to search the corresponding disease targets.…”

Section: Network Pharmacology Analysismentioning

confidence: 99%

“…Some studies (12)(13)(14)(15) have shown that if the TCM syndrome differentiation is damp-heat arthralgia syndrome, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are significantly higher in other syndrome types, and RA disease activity is the highest. For example, recent randomized controlled trials (RCTs) (16)(17)(18) have also demonstrated that the CHF for clearing dampness and heat, such as Simiao pill (SMP), Baihuguizhi decoction (BHGZD), Xuanbi decoction (XBD), combined with the csDMARD, can effectively improve RA symptoms, including reducing inflammatory reaction substances, and relieving joint pain and swelling. Concurrently, the safety of TCM has also been an issue of concern in China and internationally.…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy and safety of four classical prescriptions for clearing damp-heat recommended by clinical guidelines in treating rheumatoid arthritis: a network meta-analysis

Li¹,

Liu²,

Chen³

et al. 2021

Ann Palliat Med

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Background: In China, along with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), some herbal formulae for clearing damp-heat are widely applied in treating rheumatoid arthritis (RA). We aimed to summarize and compare the clinical effects of 4 guideline-recommended formulae, including Baihuguizhi decoction, Dangguiniantong decoction, Simiao pill, and Xuanbi decoction. Methods: PubMed, Cochrane Library, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Chinese Science and Technique Journals (CQVIP), WanFang, and SinoMed (CBM) databases were searched for randomized controlled trials from inception to July 2020 evaluating the efficacy and safety of these recommended herbal formulae combined with 1 csDMARD versus csDMARD alone in RA patients. A pairwise meta-analysis was conducted in RevMan 5.3 software, and a Bayesian network meta-analysis (NMA) was performed with Stata 14.0, R 4.0.2, GeMTC 0.14.3, and JAGS 4.3.0 software. Cochrane Handbook 5.1.0 was used to assess the risk of bias. Publication bias was evaluated using Egger's test, the trim-fill adjustment, and funnel plots. Trial sequential analysis (TSA) was performed to validate the overall results. The rank probability of interventions was calculated and clustered by the surface under the cumulative ranking curve (SUCRA). Pharmacologic actions of formulae were explored through the network pharmacology approach. Results: A total of 15 studies, including 1,079 individuals, were identified. Simiao pill + csDMARD [SMPPD, odds ratio (OR) =6.62, 95% confidence interval (CI): 2.88 to 16.84] was superior to csDMARDs alone in clinical efficiency, and was more able to reduce C-reactive protein and erythrocyte sedimentation rate levels [mean difference (MD) =−7.91, 95% CI: −17.41 to −1.25; MD =−9.31, 95% CI: −14.48 to −5.56 respectively].Although publication bias was observed (P=0.033), the trim-fill method indicated that the pooled values kept stable. Fewer adverse events (AEs) were shown with SMPPD (6.45%). TSA confirmed the results of efficacy rate at SMPPD. Network pharmacology included 5 common components and 66 common targets among 4 formulae in treating RA, involving regulating immunity and relieving inflammation.Discussion: SMPPD might be a preferable complementary therapy for RA. However, considering the limitations of this study, recommendations for clinical practice should be validated by the results of further well-designed studies.

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The role of Chinese herbal medicine in the management of adverse drug reactions of leflunomide in treating rheumatoid arthritis

Cited by 17 publications

References 125 publications

Identifying Compound Effect of Drugs on Rheumatoid Arthritis Treatment Based on the Association Rule and a Random Walking-Based Model

Identifying Compound Effect of Drugs on Rheumatoid Arthritis Treatment Based on the Association Rule and a Random Walking-Based Model

Research Progress of Therapeutic Enzymes and Their Derivatives: Based on Herbal Medicinal Products in Rheumatoid Arthritis

Comparative efficacy and safety of four classical prescriptions for clearing damp-heat recommended by clinical guidelines in treating rheumatoid arthritis: a network meta-analysis

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