Modified Si-Miao Pill for Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

Objective. The aim of this review and meta-analysis was to assess the effects and safety of modified Si-Miao pill (mSMP) in treatment of rheumatoid arthritis. Design. A systematic literature search was carried out in eight databases from their available dates of inception to April 2020. After screening, fifteen randomized, controlled trials (RCTs) comparing the effects and safety of mSMP in combination with western medicine (including disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs)) in treating rheumatoid arthritis patients were included after screening. Results. In comparison with DMARDs, or coadministration of DMARDs and NSAIDs, mSMP in combination with western medicine significantly lowered erythrocyte sedimentation rate (mean difference (MD) = -10.61, 95% confidence interval (CI) [−12.19, −9.03]), C-reactive protein (MD = −6.50, 95% CI [−8.43, −4.56]), rheumatoid factors (MD = −17.31, 95% CI [−24.34, −10.27]), swollen joint count (MD = −1.63, 95% CI [−2.29, −0.97]), tender joint count (MD = −1.98, 95% CI [−2.34, −1.62]), and morning stiffness time (MD = −24.37, 95% CI [−29.41, 19.33]) and ameliorated the condition of patients (odds ratio (OR) = 3.69, 95% CI [2.64, 5.14]). Additionally, mSMP in combination with western medicine seemed safer (OR = 0.49, 95% CI [0.30, 0.81]). Conclusion. The results of the meta-analysis study have shown that mSMP in combination with western medicine therapies appears to be more effective and safer than western medicine alone in the treatment of rheumatoid arthritis including reducing inflammatory markers and adverse events and improving symptoms. Howbeit, more high-grade, large-scale RCTs of mSMP in various countries and regions are still needed.

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Efficacy and Safety of Acupuncture with Western Medicine for Rheumatoid Arthritis: A Systematic Review and Meta-analysis

Acupuncture & Electro-Therapeutics Research ◽

10.3727/036012921x16237619666076 ◽

2021 ◽

Author(s):

Xinhui Huo ◽

Lili Liang ◽

Xia Ding ◽

Angshaer Bihazi ◽

Haiyan Xu

Keyword(s):

Western Medicine ◽

Analogue Scale ◽

English Language ◽

Meta Analysis ◽

Chinese Language ◽

Efficacy And Safety ◽

C Reactive Protein ◽

Reactive Protein ◽

Randomized Controlled ◽

Erythrocyte Sedimentation

Objectives: In the present study, we assessed the therapeutic qualities of the combination of acupuncture with Western medicine to determine further lines of clinical research. Methods: We searched English-language databases and Chinese-language databases for randomized controlled trials (RCTs) published up to February 2020. Two reviewers performed a meta-analysis of the efficacy and toxicity of the use of acupuncture with Western medicine for RA measured by a visual analogue scale (VAS), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Results: In total, 9 RCTs involving 698 patients were included for analysis. VAS, ESR, CRP, and RF were all shown to favor the combination of acupuncture with Western medicine compared to Western medicine alone. ST36 (Zusanli), EX-UE9 (Baxie), Ll11 (Quchi), GB34 (Yanglingquan), TE14 (Jianliao) and TE4(Yangchi) were frequently used in 9 clinical trials. Conclusion: Treatment using acupuncture with Western medicine was associated with higher efficacy and lower risks than treatment with Western medicine alone. ST36 (Zusanli), EX-UE9 (Baxie), Ll11 (Quchi), GB34 (Yanglingquan), TE14 (Jianliao) and TE4 (Yangchi) were frequently used in treatment of RA and had been verified with effect in clinical practice

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The Derivative of Tripterygium wilfordii Hook F—Kunxian Capsule, Attenuated Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/4178140 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Ya-Fei Liu ◽

Zhe Zhang ◽

Jun-Jun Zhang ◽

Zhe Chen ◽

Sheng-Hao Tu ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Systematic Review ◽

Meta Analysis ◽

Tender Joint ◽

Tripterygium Wilfordii Hook F ◽

Reactive Protein ◽

Randomized Controlled ◽

Tripterygium Wilfordii Hook ◽

Mean Differences ◽

Review Manager

The study aimed to explore the efficacy and safety of Kunxian Capsule (KXC) in the treatment of rheumatoid arthritis (RA). The randomized controlled trials (RCTs) comparing the effects of KXC in patients with RA were included in this study. Weighted mean differences (MDs) were calculated for net changes by employing Review Manager meta-analysis software. Nine RCTs were included in the systematic review with a total of 747 patients. The overall effects showed that KXC alone or combined with disease-modifying antirheumatic and drugs decreased tender joint counts (P=0.02, MD = −1.07, 95% CI: −1.95 to −0.18), shortened duration of morning stiffness (P<0.0001, MD = −9.01, 95% CI: −13.08 to −4.93), lowered erythrocyte sedimentation rate (P<0.00001, MD = −5.27, 95% CI: −6.78 to −3.77), and reduced C-reactive protein (P<0.0001, MD = −5.04, 95% CI: −7.28 to −2.80). The most common adverse events were gastrointestinal disturbances and abnormal liver function. These results suggest that KXC is likely to be a more effective and safe candidate for treating RA compared with conventional therapies.

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Thrombin-cleaved Osteopontin Is Increased in Urine of Patients with Rheumatoid Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.090582 ◽

2010 ◽

Vol 37 (4) ◽

pp. 704-710 ◽

Cited By ~ 12

Author(s):

KIORI SHIO ◽

HIROKO KOBAYASHI ◽

TOMOYUKI ASANO ◽

RIE SAITO ◽

HARUYO IWADATE ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Disease Activity Score ◽

Tender Joint Count ◽

Healthy Controls ◽

C Reactive Protein ◽

Tender Joint ◽

Matrix Metalloproteinase 3 ◽

Reactive Protein ◽

Urine Levels

Objective.To measure concentrations of the thrombin-cleaved isoform of osteopontin (OPN) in urine and plasma of patients with rheumatoid arthritis (RA), and to assess whether levels of thrombin-cleaved OPN are associated with measures of RA.Methods.Subjects comprised 70 patients with RA, 20 patients with osteoarthritis (OA), and 46 healthy controls. RA disease activity was evaluated by tender joint count, swollen joint count, patient’s global assessment of disease activity, erythrocyte sedimentation rate (ESR), and levels of C-reactive protein (CRP), matrix metalloproteinase-3 (MMP-3), and rheumatoid factor (RF), as well as 28-joint count Disease Activity Score (DAS28). OPN levels in plasma and urine were measured by ELISA.Results.Median levels of thrombin-cleaved OPN in urine (U-half) were significantly higher in RA patients (143.5 pmol/mmol Cr) than in healthy controls (67.9 pmol/mmol Cr) or OA patients (69.8 pmol/mmol Cr). Thrombin-cleaved OPN was not detected in plasma. U-half levels correlated significantly with levels of CRP (r = 0.26, p = 0.03), ESR (r = 0.26, p = 0.03), and RF (r = 0.28, p = 0.03). Median U-half levels were significantly higher in patients with stage III (249.9 pmol/mmol Cr) and IV (251.6 pmol/mmol Cr) disease than in patients with stage I (98.6 pmol/mmol Cr) disease.Conclusion.Our results suggest that urine levels of the thrombin-cleaved isoform of OPN may reflect the severity of active inflammatory arthritis in patients with RA.

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Effect of nonsteroidal antiinflammatory drugs on the C-reactive protein level in rheumatoid arthritis: A meta-analysis of randomized controlled trials

Arthritis & Rheumatism ◽

10.1002/art.34644 ◽

2012 ◽

Vol 64 (11) ◽

pp. 3511-3521 ◽

Cited By ~ 18

Author(s):

Simon Tarp ◽

Else M. Bartels ◽

Henning Bliddal ◽

Daniel E. Furst ◽

Maarten Boers ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Randomized Controlled Trials ◽

Protein Level ◽

Meta Analysis ◽

Nonsteroidal Antiinflammatory Drugs ◽

Controlled Trials ◽

C Reactive Protein ◽

Antiinflammatory Drugs ◽

Reactive Protein ◽

Randomized Controlled

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Serum IL-37 Level Is Associated with Rheumatoid Arthritis and Disease Activity: A Meta-Analysis

BioMed Research International ◽

10.1155/2021/6653439 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Shengnan Cao ◽

Haojun Shi ◽

Guodong Sun ◽

Yuanzhen Chen ◽

Guangjian Hou ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Meta Analysis ◽

Elevated Serum ◽

Tender Joint Count ◽

Tender Joint ◽

Reactive Protein ◽

Cytokine Levels ◽

Factor Α ◽

The Relationship

Interleukin-37 (IL-37) inhibits the pathogenesis of rheumatoid arthritis (RA) via downregulating proinflammatory cytokines. Accordingly, we performed an analysis to accurately assess the relationship between serum IL-37 cytokine levels and disease activity of RA. Subgroup analysis and sensitivity analysis were applied to explore the sources of heterogeneity. Correlation coefficient ( r ) was utilized to evaluate the relationship between IL-37 and disease activity of RA patients. Ten studies were included into the research. Functional analysis revealed elevated serum IL-37 concentrations in RA patients ( SMD = 1.61 , P < 0.00001 ). The relationship between serum IL-37 levels and disease activity was statistically significant (C-reactive protein: r = 1.47 , P = 0.0002 ; erythrocyte sedimentation rate: r = 1.55 , P < 0.00001 ; rheumatoid factor: r = 1.40 , P = 0.004 ; tumor necrosis factor⁃α: r = 1.64 , P = 0.0003 ; Disease Activity Score for 28 joints: r = 1.63 , P < 0.00001 ; tender joint count: r = 1.48 , P < 0.00001 ; and swollen joint count: r = 1.52 , P = 0.0003 ), but anti-CCP was not significant (anti-CCP: r = 0.98 , P = 0.72 ). In summary, these data are suggesting that the elevated serum level of IL-37 in RA is positively correlated with the disease activity of RA, suggesting a role for IL-37in the pathogenesis of RA.

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Effects of purslane supplementation on C‐reactive protein levels and biomarkers of oxidative stress as marks for metabolic syndrome: A systematic review and meta‐analysis of randomized controlled trials

Phytotherapy Research ◽

10.1002/ptr.7182 ◽

2021 ◽

Author(s):

Ying Zhu ◽

Yubing Huang ◽

Heitor O. Santos ◽

Caio V. C. Oliveira ◽

Hui Zhou ◽

...

Keyword(s):

Oxidative Stress ◽

Systematic Review ◽

Metabolic Syndrome ◽

Meta Analysis ◽

Controlled Trials ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Randomized Controlled ◽

Biomarkers Of Oxidative Stress

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MRI in early rheumatoid arthritis: synovitis and bone marrow oedema are independent predictors of subsequent radiographic progression

Annals of the Rheumatic Diseases ◽

10.1136/ard.2009.123950 ◽

2010 ◽

Vol 70 (3) ◽

pp. 428-433 ◽

Cited By ~ 88

Author(s):

Pernille Bøyesen ◽

Espen A Haavardsholm ◽

Mikkel Østergaard ◽

Désirée van der Heijde ◽

Sølve Sesseng ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Bone Marrow ◽

Early Rheumatoid Arthritis ◽

Radiographic Progression ◽

Bone Marrow Oedema ◽

Tender Joint Count ◽

X Rays ◽

Tender Joint ◽

Reactive Protein

ObjectivesTo determine whether MRI and conventional (clinical and laboratory) measures of inflammation can predict 3-year radiographic changes measured by the van der Heijde Sharp score in patients with early rheumatoid arthritis (RA).Methods55 patients with RA with disease duration <1 year participated in this 3-year follow-up study. Patients were evaluated at baseline, 3, 6, 12 and 36 months by swollen and tender joint count, disease activity score based on 28-joint count, erythrocyte sedimentation rate (ESR), C reactive protein, MRI measures of synovitis, bone marrow oedema and tenosynovitis of the dominant wrist, as well as conventional x-rays of the hands and wrists.ResultsAll measures of inflammation decreased during the follow-up period. ESR, MRI synovitis and MRI bone marrow oedema were independent predictors of 3-year radiographic progression adjusted for age, sex and anti-citrullinated protein antibodies. The 1-year cumulative measures of MRI synovitis and bone marrow oedema provided an improved explanation of variation (adjusted R2) in radiographic change compared with the baseline MRI values (adjusted R2=0.32 and 0.20 vs 0.11 and 0.04, respectively).ConclusionsBoth baseline and 1-year cumulative measures of MRI synovitis and bone marrow oedema independently predicted 3-year radiographic progression. These results confirm that MRI synovitis and MRI bone marrow oedema precede radiographic progression in patients with early RA.

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