Total glucosides of paeony for rheumatoid arthritis: A systematic review of randomized controlled trials

Luo, Jing; Jin, Di-Er; Yang, Guoyan; Zhang, Yingze; Wang, Jianming; Kong, Wan Yee; Tao, Qing-Wen

doi:10.1016/j.ctim.2017.07.010

Cited by 46 publications

(25 citation statements)

References 22 publications

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“…Rehd. & Wils [139][140] and total glucosides of peony are from Paeonia lactiflora Pall., [141][142][143]. Interestingly, the plant Tripterygium wilfordii Hook F (lei gong teng) which has also been developed into therapies for RA [144][145][146][147], did not appear in any of the formulas located in this text-mining study.…”

Section: Modern Research Into Herbs Used Frequently In Thementioning

confidence: 79%

Chinese Herbal Medicines for Rheumatoid Arthritis: Text‐Mining the Classical Literature for Potentially Effective Natural Products

Xia

May

Zhang

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Background. Rheumatoid arthritis (RA) is an autoimmune disease characterized by multijoint swelling, pain, and destruction of the synovial joints. Treatments are available but new therapies are still required. One source of new therapies is natural products, including herbs used in traditional medicines. In China and neighbouring countries, natural products have been used throughout recorded history and are still in use for RA and its symptoms. This study used text-mining of a database of classical Chinese medical books to identify candidates for future clinical and experimental investigations of therapeutics for RA. Methods. The database Encyclopaedia of Traditional Chinese Medicine (Zhong Hua Yi Dian) includes the full texts of over 1,150 classical books. Eight traditional terms were searched. All citations were assessed for relevance to RA. Results and Conclusions. After removal of duplications, 3,174 citations were considered. After applying the exclusion and inclusion criteria, 548 citations of traditional formulas were included. These derived from 138 books written from 206 CE to 1948. These formulas included 5,018 ingredients (mean, 9 ingredients/formula) comprising 243 different natural products. When these text-mining results were compared to the 18 formulas recommended in a modern Chinese Medicine clinical practice guideline, 44% of the herbal formulas were the same. This suggests considerable continuity in the clinical application of these herbs between classical and modern Chinese medicine practice. Of the 15 herbs most frequently used as ingredients of the classical formulas, all have received research attention, and all have been reported to have anti-inflammatory effects. Two of these 15 herbs have already been developed into new anti-RA therapeutics—sinomenine from Sinomenium acutum (Thunb.) Rehd. & Wils and total glucosides of peony from Paeonia lactiflora Pall. Nevertheless, there remains considerable scope for further research. This text-mining approach was effective in identifying multiple natural product candidates for future research.

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Section: Modern Research Into Herbs Used Frequently In Thementioning

confidence: 79%

Chinese Herbal Medicines for Rheumatoid Arthritis: Text‐Mining the Classical Literature for Potentially Effective Natural Products

Xia

May

Zhang

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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“…The total glucosides of paeony (TGP) is the active compound extracted from the roots of Paeonia lactiflora Pall, a traditional Chinese medicinal herb, which has been reported with analgesic, anti-inflammatory, immunomodulatory, and antioxidant functions (He and Dai, 2011; Luo et al, 2016, 2017). TGP has been approved by the China Food and Drug Administration to be applied treating RA in 1998, then it has been used for the treatment of SLE and SS (Zhang and Dai, 2012; Zhao et al, 2012; Li et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness and Safety of Total Glucosides of Paeony in Primary Sjögren's Syndrome: A Systematic Review and Meta-Analysis

et al. 2019

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Objective: To assess the effectiveness and safety of the total glucosides of paeony (TGP) on the treatment of primary Sjögren's syndrome (pSS) by conducting a meta-analysis. Methods: Eight databases were searched from their inception to December 10, 2018 for randomized controlled trials (RCTs). The Revman 5.3 software was used for this meta-analysis. Results: Nine RCTs which included 770 participants were identified. Pooled results showed that significant difference in Schirmer's test ( P < 0.00001) comparing TGP with placebo (PBO). However, the pooled results displayed significant differences in salivary flow rate, Schirmer's test, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), serum γ-globulin, immunoglobulin G (IgG), IgA, IgM, and effective rate ( P ≤ 0.01) in the co-administration of TGP with immunosuppressant (IS) compared with IS alone. Subgroup analyses revealed both heterogeneities in ESR and serum γ-globulin were eliminated, showing combined intervention of TGP + IS being more advantageous than single usage of IS ( P < 0.00001). However, the advantage varied among three subgroups and showed a gradual weakening over time. Furthermore, our results showed statistical significance in Schirmer's test ( P = 0.0006), when hydroxychloroquine (HCQ) was jointly applied, but not in the case of combined TGP with methotrexate (MTX) ( P = 0.41). For the safety analysis, the most common adverse events (AEs) were diarrhea or gastrointestinal discomfort, and no severe AEs were reported in TGP group. Meanwhile, six trials showed statistically insignificant differences between TGP + IS and IS in AEs ( P = 0.76). Conclusions: Improving the lacrimal gland secretion (Schirmer's test) is the prominent function of TGP compared with PBO. TGP + IS can improve the clinical symptoms, such as lacrimal and salivary gland secretion function (Schirmer's test, salivary flow rate), inflammatory indices (ESR, CRP, and RF) and immunoglobulins (γ-globulin, IgG, IgA, and IgM) on the basis of IS monotherapy. In addition, TGP has an acceptable safety profile and AEs were not increased when TGP combined with IS in pSS. Therefore, TGP can be considered to be a potentially valid and safe drug for the treatment of pSS in the clinic. In view of the limitations of the included trials, the potential beneficial effectiveness and safety of TGP need additional high-quality, multi-center, and large-scale RCTs to assess its use in pSS treatment.

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“…The original protocol of this systematic review has been documented in PROSPERO (ID=CRD42015026345). 19 This is a revised version which will also be uploaded to PROSPERO. 19 The systematic review will be conducted according to the revised protocol and reported in accordance with the PRISMA statement.…”

Section: Methods and Analysismentioning

confidence: 99%

Total glucosides of paeony for rheumatoid arthritis: a protocol for a systematic review

et al. 2016

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Introduction Total glucosides of paeony (TGP) is a natural plant extract, which is widely used in China for treating rheumatoid arthritis (RA). Many relevant randomised controlled trials (RCTs) of TGP for RA are available, but they have not been systematically reviewed. This systematic review aims to examine the effectiveness and safety of TGP in patients with RA. Methods and analyses We will search for RCTs of TGP in the treatment of RA, performed up until February 2016, in PubMed, Embase, Cochrane Central Register of Controlled Trials, and four Chinese databases (Chinese Biomedical Database, China National Knowledge Infrastructure, Wanfang Database and Chinese Scientific Journal Database). Trial registers and reference lists of retrieved articles will also be searched to identify potential articles. RCTs comparing TGP with placebo, no treatment, or disease-modifying antirheumatic drugs for patients with RA will be retrieved. The primary outcomes will be disease improvement and disease remission. The secondary outcomes will be surrogate outcomes, symptoms, adverse effects, and quality of life. Two reviewers will independently extract data on participants, interventions, comparisons, outcomes, etc. The methodological quality of each included study will be evaluated using the Cochrane risk of bias tool, and the strength of evidence on prespecified outcomes will be assessed in accordance with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Review Manager 5.3 software will be used for data analyses. Meta-analyses will be performed if the data are sufficiently homogeneous, both statistically and clinically. Possible publication bias will also be checked using funnel plots once the number of included studies is sufficient. Ethics and dissemination Ethics approval is not required, as this study will not involve patients. The results of this study will be submitted to a peer-reviewed journal for publication, to inform both clinical practice and further research. Trial registration number CRD42015026345.

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Total glucosides of paeony for rheumatoid arthritis: A systematic review of randomized controlled trials

Cited by 46 publications

References 22 publications

Chinese Herbal Medicines for Rheumatoid Arthritis: Text‐Mining the Classical Literature for Potentially Effective Natural Products

Chinese Herbal Medicines for Rheumatoid Arthritis: Text‐Mining the Classical Literature for Potentially Effective Natural Products

The Effectiveness and Safety of Total Glucosides of Paeony in Primary Sjögren's Syndrome: A Systematic Review and Meta-Analysis

Total glucosides of paeony for rheumatoid arthritis: a protocol for a systematic review

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