Wang Hai-Long, Zhao Qi, Li Wei, Zhu Hua-Chao, Lv Liu, Zhu Zhen-Hong, Wang Xi-Xi, Yang Zheng-Zheng, Ma Yu-Cao, Liu Ming-Xuan, Wang Yi-Wen, Lai Hezheng, Liu Chun-Ping, Yang Yu-Zheng
Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China.
Chinese Medicine Centre, Western Sydney University, Penrith, NSW 2751, Australia.
Evid Based Complement Alternat Med. 2022 May 10;2022:3181427. doi: 10.1155/2022/3181427. eCollection 2022.
This study aims to evaluate the efficacy of various conventional synthetic DMARDs, including Hook F (TwHF) for treating rheumatoid arthritis (RA) by network meta-analysis.
We retrieved the related literature from online databases and supplemented it by using a manual retrieval method. Data was extracted from the literature and analyzed with STATA software.
A total of 21 trials (5,039 participants) were identified. Assessment of ACR20 response found that TwHF combined with methotrexate (MTX) had the greatest probability for being the best treatment option among the treatments involved, while TwHF used singly was second only to TwHF combined with MTX. Assessment of ACR50 response found that TwHF combined with MTX ranked second in all treatment options after cyclosporine A (CsA) combined with leflunomide (LEF) and TwHF alone, followed by TwHF combined with MTX. Assessment of ACR70 response found that CsA combined with LEF ranked first, TwHF combined with LEF ranked second, TwHF combined with MTX ranked third, and TwHF used singly ranked fourth. In the safety analysis, TwHF had the least probability of adverse event occurrence, followed by TwHF combined with MTX, which ranked first and second, respectively.
Compared with the current csDMARDs for treating RA, the efficacy of TwHF was clear, and TwHF combined with MTX performed well under various endpoints. In the future, large, rigorous, and high-quality RCTs are still needed to confirm the benefits of TwHF therapy on RA.
本研究旨在通过网状Meta分析评估包括雷公藤多苷（TwHF）在内的各种传统合成抗风湿药物（DMARDs）治疗类风湿关节炎（RA）的疗效。
我们从在线数据库检索相关文献，并采用手工检索方法进行补充。从文献中提取数据并用STATA软件进行分析。
共纳入21项试验（5039名参与者）。美国风湿病学会20%改善标准（ACR20）反应评估发现，TwHF联合甲氨蝶呤（MTX）在所有参与治疗中成为最佳治疗方案的概率最高，而单独使用TwHF仅次于TwHF联合MTX。美国风湿病学会50%改善标准（ACR50）反应评估发现，TwHF联合MTX在所有治疗方案中仅次于环孢素A（CsA）联合来氟米特（LEF）和单独使用TwHF，位居第二。美国风湿病学会70%改善标准（ACR70）反应评估发现，CsA联合LEF排名第一，TwHF联合LEF排名第二，TwHF联合MTX排名第三，单独使用TwHF排名第四。在安全性分析中，TwHF发生不良事件的概率最低，其次是TwHF联合MTX，分别排名第一和第二。
与目前用于治疗RA的传统合成DMARDs相比，TwHF的疗效明确，TwHF联合MTX在各个终点指标下表现良好。未来仍需要大规模、严谨且高质量的随机对照试验（RCT）来证实TwHF治疗RA的益处。
