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Meta-Analysis of Tripterygium Wilfordii Hook F in the Immunosuppressive Treatment of IgA Nephropathy
- Source :
- Internal Medicine. 49:2049-2055
- Publication Year :
- 2010
- Publisher :
- Japanese Society of Internal Medicine, 2010.
-
Abstract
- Objective Numerous Chinese patients with IgA nephropathy (IgAN) have benefited from Tripterygium wilfordii Hook F (TwHF) from two decades ago. However, to date there is no systematic evaluation of this remedy for IgAN. Methods We conducted a meta-analysis of all eligible randomized clinical trials (RCTs) to assess the effect of TwHF on IgAN for the first time. In August 2009 a systematic search was performed among eight electronic databases. Review Manager (RevMan) version 5.0 was used. Results (i) Four eligible RCTs with 188 participants were included; (ii) The validities of included RCTs were generally acceptable; (iii) TwHF brought about a favorable increase in complete remission (CR) (RR 1.53, 95%CI 1.09 to 2.16, I2=12%) and total remission (TR) (RR 1.27, 95%CI 1.08 to 1.48, I2=0%) compared with non-TwHF treatment; and this result was further confirmed by intention-to-treat analysis; (iv) Exploiting subgroup meta-analysis, TwHF led to significantly greater improvements of IgAN with non-nephrotic proteinuria with regard to the increase of CR (RR 1.80, 95%CI 1.21 to 2.68, I2=0%) and TR (RR 1.32, 95%CI 1.11 to 1.57, I2=0%), and decrease of urinary proteinuria excretion (UPE) (MD -467.41 mg/24h, 95%CI -633.99 to -300.82, I2=0%). Meanwhile, the renal function was well preserved (MD -2.66 μmol/L, 95%CI -9.26 to 3.94, I2=0%). Conclusion Although the results of this meta-analysis should be interpreted with caution and warrant further investigation, TwHF was certainly a valuable and promising immunosuppressive remedy for IgAN, which was in accordance with the accruing evidence from numerous large clinical and experimental studies.
- Subjects :
- Male
China
medicine.medical_specialty
Tripterygium
Gastroenterology
law.invention
Nephropathy
Randomized controlled trial
law
Internal medicine
Internal Medicine
medicine
Humans
Randomized Controlled Trials as Topic
Proteinuria
biology
business.industry
Remission Induction
Glomerulonephritis, IGA
General Medicine
medicine.disease
biology.organism_classification
Treatment Outcome
Meta-analysis
Rheumatoid arthritis
Immunology
Female
Tripterygium wilfordii
medicine.symptom
business
Nephrotic syndrome
Immunosuppressive Agents
Drugs, Chinese Herbal
Phytotherapy
Subjects
Details
- ISSN :
- 13497235 and 09182918
- Volume :
- 49
- Database :
- OpenAIRE
- Journal :
- Internal Medicine
- Accession number :
- edsair.doi.dedup.....8cb306a5e2b3f23965bf932fcbe98135