The efficacy of the traditional Chinese medicine Jia Wei Niu Bang Zi granule combined with methotrexate in treating active rheumatoid arthritis: A multicenter, randomized, double-blinded controlled clinical trial

Huangqin Qingre Chubi Capsule is Associated with Reduced Risk of Readmission in Patients with Rheumatoid Arthritis: A Real-World Retrospective Cohort Study

Purpose

The therapeutic effects of Huangqin Qingre Chubi (HQC) in rheumatoid arthritis (RA) have been documented. However, there is a lack of real-world clinical evidence supporting its efficacy.

Methods

Patients diagnosed with RA were recruited from the First Affiliated Hospital of the Anhui University of Chinese Medicine. Patient information was obtained from the hospital's database. Propensity score matching (PSM), Kaplan-Meier curve, and Cox proportional hazards model were used to control confounding factors and analyze the factors influencing readmission. Association rule analysis and random walk evaluation models were used to evaluate the correlations among HQC treatment, inflammation indicators, and self-perception of patients (SPP) scale.

Results

After PSM, 3423 patients were enrolled, with 1142 in the HQC group and 2281 in the non-HQC group. The readmission risk of the HQC group was significantly lower than that of the non-HQC group. Combined univariate and multivariate analysis results revealed that risk factors for readmission were age >60 years, female sex, hypertension, chronic gastritis, and elevated levels of laboratory indices, including anticyclic citrullinated peptide and complement component 3 (C3) and C4. HQC, disease-modifying antirheumatic drugs, nonsteroidal anti-inflammatory drugs, and glucocorticoid therapy were protective factors for readmission. HQC treatment was closely associated with improvements in many factors, including erythrocyte sedimentation rate, C-reactive protein, C3, rheumatoid factor levels, visual analog scale, depression self-assessment scale, and patient-reported activity index scores with RA.

Conclusion

HQC treatment can reduce the risk of readmission and significantly improve immune inflammatory indicators and SPP in patients with RA, with no risk of hepatorenal toxicity.

Efficacy and Safety of Qiwei Tongbi Oral Liquid in Patients with Stable Long-Standing Rheumatoid Arthritis

Objective

Our study is aimed at investigating the efficacy and safety of Qiwei Tongbi oral liquid in patients with stable long-standing rheumatoid arthritis (RA).

Method

140 patients with stable long-standing RA were recruited into the Qiwei Tongbi oral liquid group or the control group. At study recruitment and after 12 weeks of treatment, their C-reactive protein (CRP) levels, interleukin-6 (IL-6) levels, erythrocyte sedimentation rate (ESR), Health Assessment Questionnaire (HAQ), visual analogue scale (VAS), and Disease Activity Score (DAS) 28 were compared in two groups.

Results

Patients in the Qiwei Tongbi oral liquid group had a lower level of CRP, IL-6, VAS scale, and HAQ score compared to patients in the control group (CRP: 3.51 ± 1.57 vs.5.47 ± 1.72 mg/L, P < 0.001; IL-6: 1.62 ± 0.8 vs. 2.19 ± 0.88 pg/mL, P < 0.001; VAS scale: 1.59 ± 0.69 vs. 2.66 ± 1.02, P < 0.001; and HAQ score: 1.19 ± 0.46 vs. 1.41 ± 0.50, P = 0.005). The ESR and DAS28 did not reach statistical difference. No damage to liver and kidney functions was observed in both groups.

Conclusion

Qiwei Tongbi oral liquid has the tendency to decrease the inflammation levels and pain score and improve patients' outcomes in patients with stable long-standing RA.

Traditional Chinese medicine on treating active rheumatoid arthritis: A protocol for systematic review and meta-analysis

BACKGROUND

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease associated with progressive joint damage and disability. There is a lack of effective methods in the treatment of RA currently. Many clinical trials have proved that traditional Chinese medicine (TCM) has obvious advantages in the treatment of RA. In this systematic review, we intend to evaluate the efficacy and safety of TCM for active RA.

METHODS

We will search PubMed, the Cochrane Library, Embase, Web of Science, the Chinese National Knowledge Infrastructure Database, Wanfang Data, and Chinese Science and Technology Periodical Database. Simultaneously we will retrieval relevant meeting minutes, eligible research reference lists, symposium abstracts, and grey literatures. Included criteria are randomized controlled trials (RCTs) about TCM for active RA to assess its efficacy and safety. We will use the Revman 5.3 and Stata 13.0 software for data synthesis, sensitivity analysis, meta regression, subgroup analysis, and risk of bias assessment. The Grading of Recommendations Assessment, Development, and Evaluation standard will be used to evaluate the quality of evidence.

RESULTS

This systematic review will provide a synthesis of TCM for patients with active RA from various evaluation aspects including tender joint count, swollen joint count, RF, CRP, ESR, DAS28, TCM syndrome evaluation criteria, and adverse events.

CONCLUSION

The systematic review will provide evidence to assess the efficacy and safety of TCM in the treatment of patients with active RA.

PROSPERO REGISTRATION NUMBER

PROSPERO CRD42019146726.