Effects and safety of Sinomenine in treatment of rheumatoid arthritis contrast to methotrexate: a systematic review and Meta-analysis

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• 作者：Liu Weiwei^a ; Qian Xian^b ; Ji Wei^b ; Lu Yan^b ; Wei Gang^b ; Wang Yue^b ; ^{wangyuephd@126.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Sinomenine ; Randomized controlled trials ; Arthritis ; rheumatoid ; Methotrexate ; Meta-analysis
• 刊名：Journal of Traditional Chinese Medicine
• 出版年：2016
• 出版时间：15 October 2016
• 年：2016
• 卷：36
• 期：5
• 页码：564-577
• 全文大小：4665 K

文摘

To systematically evaluate the curative clinical efficacy and safety of sinomenine (SIN) in treatment of rheumatoid arthritis (RA) in comparison to methotrexate (MTX).

METHODS

We searched the China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, China Science and Technology Journal Database, Wanfang Database, Pubmed and Cochrane Library electronically up to August 31, 2015, without language limitation. Only randomized controlled trials (RCTs) were included. Software Review Manager 5.3 was used for Meta-analysis.

RESULTS

A total of 16 eligible studies within 1500 RA patients were included. The meta-analysis indicated that on basis of MTX, SIN was more effective in total effective rate (P < 0.00001). Besides, SIN alone versus MTX also showed advantages in RA therapy (P = 0.04)Taken together, adverse events occurred less frequently in combination of SIN and MTX than MTX alone (P < 0.000 1), especially in digestive system (P < 0.000 01), while occurred more in dermato mucosal system with SIN treatment versus MTX (P = 0.02), and were similar for both remedies in nervous system (P = 0.12) and hematological system (P = 0.25).

CONCLUTIONS

Compared to MTX, SIN had better clinical efficacy and relatively fewer adverse events in treatment of RA, especially when it was used together with MTX. Due to the poor methodological quality, well-designed, multiple-center RCTs are still required to further confirm the findings.