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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.

Systematic review and meta-analysis.

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.

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.

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).

Suboptimal study quality, significant heterogeneity in the primary outcome.

Tripterygium preparations may have nephroprotective effects, but high-quality trials are required to reliably determine the balance of benefits and harms.
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Created: Thu, 07 Aug 2014, 16:57:42 CST