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Tripterygium preparations for the treatment of CKD: A systematic review and meta-analysis

Zhu, B, Wang, Ying, Jardine, Meg, Jun, Min, Lv, Jicheng, Cass, Alan, Liyanage, Thaminda, Chen, Hong-Yu, Yong-jun, Wang and Perkovic, Vlado (2013). Tripterygium preparations for the treatment of CKD: A systematic review and meta-analysis. American Journal of Kidney Diseases,62(3):515-530.

Document type: Journal Article

IRMA ID 11035xPUB77
Title Tripterygium preparations for the treatment of CKD: A systematic review and meta-analysis
Author Zhu, B
Wang, Ying
Jardine, Meg
Jun, Min
Lv, Jicheng
Cass, Alan
Liyanage, Thaminda
Chen, Hong-Yu
Yong-jun, Wang
Perkovic, Vlado
Journal Name American Journal of Kidney Diseases
Publication Date 2013
Volume Number 62
Issue Number 3
ISSN 0272-6386   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84883219051
Start Page 515
End Page 530
Total Pages 16
Place of Publication United States
Publisher W.B. Saunders Co.
HERDC Category C1 - Journal Article (DIISR)
Abstract BACKGROUND: Preparations of the herb Tripterygium wilfordii Hook F are used widely for the treatment of chronic kidney disease in China. The efficacy and safety of Tripterygium preparations still have not been fully identified.

STUDY DESIGN:
Systematic review and meta-analysis.

SETTING & POPULATION:
Patients with chronic kidney disease.

SELECTION CRITERIA FOR STUDIES: Randomized controlled trials.

INTERVENTION: Tripterygium preparations (Tripterygium glycoside tablets, Tripterygium hypoglaucum Hutch tablets, and Tripterygium granules or extracts) versus placebo, standard care, or other immunosuppressive treatment.

OUTCOMES:
Weighted mean difference and summary estimates of relative risk (RR) reductions with 95% CIs were calculated with a random-effects model. Outcomes analyzed included change in proteinuria, serum creatinine level, and creatinine clearance rate, as well as remission and relapse rate and drug-related adverse events.

RESULTS:
We identified 75 trials that included 4,386 participants. Overall, Tripterygium therapy reduced proteinuria by protein excretion of 628 (95% CI, -736 to -521) mg/d and reduced serum creatinine level by 0.12 (95% CI, -0.17 to -0.06) mg/dL compared with controls (both P < 0.001) in a range of kidney conditions. Tripterygium preparations also increased the rate of complete remission by 56% (95% CI, 32%-85%; P < 0.001) and of complete or partial remission by 24% (95% CI, 17%-31%; P < 0.001) while reducing relapse by 58% (95% CI, 42%-69%; P < 0.001). Tripterygium preparations increased the rate of liver function test result abnormalities (RR, 4.03; 95% CI, 2.24-7.25; P < 0.001) and altered menstruation (RR, 5.29; 95% CI, 2.09-13.38; P < 0.001).

LIMITATIONS:
Suboptimal study quality, significant heterogeneity in the primary outcome.

CONCLUSIONS:
Tripterygium preparations may have nephroprotective effects, but high-quality trials are required to reliably determine the balance of benefits and harms.
DOI http://dx.doi.org/10.1053/j.ajkd.2013.02.374   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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Created: Thu, 07 Aug 2014, 16:57:42 CST