Meta-analysis of efficacy and safety of sinomenine combined with methotrexate in treatment of rheumatoid arthritis.
10.19540/j.cnki.cjcmm.20200322.501
- Author:
Cheng ZENG
1
;
Yun-Fei SHUAI
2
;
Xin LI
3
Author Information
1. School of Chinese Medicine, Hunan University of Chinese Medicine Changsha 410208, China.
2. the First Hospital of Hunan University of Chinese Medicine Changsha 410007, China.
3. School of Chinese Medicine, Hunan University of Chinese Medicine Changsha 410208, China Hunan Provincial Key Laboratory of Diagnostic and Therapeutic Research in Chinese Medicine, Hunan University of Chinese Medicine Changsha 410208, China.
- Publication Type:Meta-Analysis
- Keywords:
Meta-analysis;
combination therapy;
methotrexate;
rheumatoid arthritis;
sinomenine
- MeSH:
Antirheumatic Agents/adverse effects*;
Arthritis, Rheumatoid/drug therapy*;
Drugs, Chinese Herbal/adverse effects*;
Humans;
Methotrexate/adverse effects*;
Morphinans
- From:
China Journal of Chinese Materia Medica
2021;46(1):214-224
- CountryChina
- Language:Chinese
-
Abstract:
To systemically evaluate the efficacy and safety of sinomenine combined with methotrexate(SIN+MTX) in the treatment of rheumatoid arthritis(RA). Literature databases of Wanfang, CNKI, VIP, SinoMed, PubMed, Cochrane Library and Web of Science were retrieved comprehensively for relevant clinical trials. The literature retrieval time was from database establishment to February 4, 2020. The quality of literatures was assessed by the Cochrane Evaluation Handbook 5.1.0, and qualified literature was reviewed and analyzed by using the RevMan 5.3 statistical software. Twenty randomized controlled trials met the inclusion criteria, and were enrolled in the Meta-analysis. The results showed that SIN+MTX remarkably reduced DAS28(MD=-0.85, 95%CI[-1.03,-0.67], P<0.000 01), and improved total efficiency(P<0.000 01). SIN+MTX could inhibit swollen joint count(MD=-1.19, 95%CI[-1.75,-0.63], P<0.000 1), tender joint count(MD=-1.58, 95%CI[-2.89,-0.28], P=0.02) and reduce morning stiffness time(MD=-8.44, 95%CI[-11.82,-5.07], P<0.000 01) compared with control group. The results showed that SIN+MTX was equal to control group in grip strength(SMD=0.20,95%CI[-1.11,1.51],P=0.77). SIN+MTX remarkably alleviated the erythrocyte sedimentation rate(MD=-9.87, 95%CI[-14.52,-5.22], P<0.000 1), C-reactive protein(SMD=-0.30, 95%CI[-0.51,-0.09], P=0.005), and rheumatoid factor(MD=-11.23,95%CI[-13.81,-8.65],P<0.000 01). The frequency of adverse reactions were reduced compared with that in the control group(P<0.000 01). Current clinical studies demonstrate that the efficacy and safety of SIN+MTX in the treatment of RA were superior to control group. However, due to the low quality and quantity of the included studies, high-quality randomized controlled trials are necessary to support the clinical evidences.
