Abstract:
Background: Tripterygium glycosides have been used to treat systemic lupus erythematosus (SLE) for a long time, showing the effects of immune regulation. We aimed to evaluate the benefits and risks of Tripterygium Glycosides Tablets (TGT) for patients with SLE. Methods: We searched electronic databases and clinical trial registries for relevant randomized controlled trials (RCTs). We identified eligible RCTs and assessed risk of bias. We conducted a meta-analysis to estimate the pooled effects. The Trial Sequential Analysis (TSA) 0.9.5.10 software was used to verify the reliability of the results. Results: Eight RCTs encompassing 538 patients with SLE were included. TGT combined with conventional treatments (CTs) was superior to CTs alone in reducing lupus activity (MD = -1.66, 95% CI = -2.07 to -1.26, p < 0.00001, low-certainty evidence) and improving overall response rate (ORR) (RR = 1.21, 95% CI = 1.11 to 1.32, p < 0.0001, moderate-certainty evidence). The robustness of the results was confirmed by TSA. Regarding safety, there was no statistical difference in the overall incidence of adverse reactions between the two groups. Conclusion: In patients with SLE, TGT might safely reduce disease activity. However, further high-quality studies are needed to firmly establish the clinical efficacy of TGT. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022300474; Identifier: CRD42022300474.
摘要:
背景:雷公藤多甙长期用于治疗系统性红斑狼疮(SLE),显示免疫调节的效果。我们旨在评估雷公藤多苷片(TGT)对SLE患者的益处和风险。方法:我们在电子数据库和临床试验注册中心搜索相关的随机对照试验(RCTs)。我们确定了合格的随机对照试验并评估了偏倚风险。我们进行了荟萃分析来估计合并效应。采用试验序列分析(TSA)0.9.5.10软件验证结果的可靠性。结果:共纳入8个RCT,包括538例SLE患者。TGT联合常规治疗(CTs)在减少狼疮活动(MD=-1.66,95%CI=-2.07至-1.26,p<0.00001,低确定性证据)和改善总体反应率(ORR=1.21,95%CI=1.11至1.32,p<0.0001,中度确定性证据)方面优于单独CTs。TSA证实了结果的稳健性。关于安全,两组不良反应总发生率无统计学差异.结论:在SLE患者中,TGT可以安全地减少疾病活动。然而,需要进一步的高质量研究来确定TGT的临床疗效.系统审查注册:https://www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42022300474;标识符:CRD42022300474。