Effectiveness of antiplatelet drugs for the prevention of diabetic nephropathy: A meta-analysis of randomized controlled trials

Background. Jinshuibao capsules (JSB) have been widely used to treat early diabetic nephropathy (DN), but the specific effects are still inconsistent. A meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the clinical efficacy of JSB for early DN. Methods. Four international databases and four Chinese databases were searched from publication dates to March 1, 2018. The RCTs reporting the results of JSB’s specific effects were included, and comparisons were between JSB combined with Angiotensin Receptor Blockers (ARBs) as experimental intervention and ARBs as the control. Included studies’ quality was evaluated and the extracted data were analyzed with RevMan 5.3 software. Results. Twenty-six RCTs including 2198 early DN participants were adopted in the meta-analysis. The results showed that, compared with the ARBs alone, JSB could remarkably improve the ORR (OR = 3.84; 95% CI: 2.37~6.24; P<0.00001) and decrease 24 h UTP (MD = −93.32; 95% CI: −128.60 ~-58.04; P<0.00001), UAER (MD = −24.02; 95% CI: −30.93 ~-17.11; P<0.00001), BUN (MD = −0.26; 95%: −0.44 ~-0.08; P=0.005), Scr (MD = −9.07; 95% CI: −14.26 ~-3.88; P=0.0006), ACR (MD = −17.55; 95% CI: −22.81 ~-12.29; P<0.00001), Cys-C (MD = −0.60; 95% CI: −0.88 ~-0.32; P<0.00001), SBP (MD = −3.08; 95% CI: −4.65 ~-1.52; P=0.0001), DBP (MD = −2.09; 95% CI: −4.00 ~-0.19; P=0.03), and TG (MD = −0.36; 95% CI: −0.50 ~-0.21; P<0.00001). However, it showed no significant differences in TC (MD = −0.32; 95% CI: −0.69~0.04; P=0.08), FBG (MD = 0.04; 95% CI: −0.39~0.47; P=0.87), HbA1c (MD = −0.26; 95% CI: −0.59~0.06; P=0.11), and β2-MG (MD = −15.61; 95% CI: −32.95~1.73; P=0.08). Conclusions. This study indicates that JSB is an effective accessory therapeutic medicine for patients with early DN. It contributes to decreasing blood pressure and the content of triglyceride and improving the renal function of early DN patients. However, there is still a need to further verify the auxiliary therapeutic effect of JSB with more strictly designed RCTs with large sample and multiple centers in the future.

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Effect of safflower yellow on early type II diabetic nephropathy: a systematic review and meta-analysis of randomized controlled trials

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2018-0425 ◽

2019 ◽

Vol 32 (7) ◽

pp. 653-665

Author(s):

Xinchen Wang ◽

Yumin Xu ◽

Chenliang Chu ◽

Hongying Li ◽

Jia Mi ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Randomized Controlled Trials ◽

Blood Sugar ◽

Full Text ◽

Western Medicine ◽

Meta Analysis ◽

Biomedical Literature ◽

Cochrane Library ◽

Controlled Trials ◽

Randomized Controlled

Abstract Diabetic nephropathy (DN) is considered as one of the most popular microvascular complications of diabetes and the leading cause of death among diabetic patients. Currently, even though safflower yellow (SY) is widely adapted in the clinical treatment of DN, no meta-analysis can guarantee the safety of this treatment. This paper aims to evaluate the dominant method of SY on DN disease. The reliable source of information for randomized controlled trials (RCTs) and clinical research is listed as follows: the Chinese Biomedical Literature database, Chongqing VIP, Embase, the Cochrane Library and the China Academic Journals Full-text Database (CNKI). The CNKI search included Chinese journal articles, the full-text of important conferences and dissertations up to March 30, 2017. We picked out some particularly influential outcome variables including urinary albumin excretion rate (UAER), fasting blood sugar (FBG), blood urea nitrogen (BUN) and high-sensitivity C-reactive protein (hs-CRP) in each extracted study. In total, 1289 participants were included in this meta-analysis. The efficacy of SY alone or combined with Western medicine in the treatment of DN was better with statistically significant factors (odds ratio [OR] = 3.6, 95% confidence interval [CI] [2.37, 5.47], p < 0.00001). We found that SY lessened the UAER, heightened the proportion of blood sugar and beneficially improved other detective indicators related to DN. Therefore, SY used alone or in combination with Western medicine was significantly more efficacious with lower toxicity than Western medicine alone.

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Efficacy of tripterygium glycosides for diabetic nephropathy: a meta-analysis of randomized controlled trials

BMC Nephrology ◽

10.1186/s12882-021-02487-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Hua-Bin Guo ◽

Jia-Qing Peng ◽

Xuan Wang ◽

Ke-Kai Zhang ◽

Guang-Zhi Zhong ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Biomedical Literature ◽

Controlled Trials ◽

Total Efficiency ◽

China National Knowledge Infrastructure ◽

Randomized Controlled ◽

Clinical Complications ◽

Tripterygium Glycosides

Abstract Backgrounds Diabetic nephropathy (DN) is one of the most important clinical complications of diabetes mellitus (DM) and is the most common cause of end-stage renal disease. Currently, there is no highly effective medicine that can prevent, halt, or reverse the progressive course of DN. Initial clinical data showed that Tripterygium glycosides (TGs), a traditional Chinese medicine, can decrease proteinuria in patients with DN. Objectives The objective of the present study is to investigate the efficacy and safety of TGs for the treatment of DN through meta-analysis of randomized controlled trials (RCTs). Methods All RCTs of TGs for DN were collected from The China National Knowledge Infrastructure (CNKI), PubMed, Web of Science, Wanfang Data, Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (VIP) by setting the study inclusion and elimination standards. Two reviewers evaluated the quality of the trials and extracted the data independently. RevMan 5.4 software was used for meta-analyses. The primary outcome was a change in 24-hours urinary total protein (24 h TUP). Results 26 RCTs with 1824 participants were identified. Studies were assessed using the Cochrane risk of bias tool. The overall effects showed that TGs was compared with the controls, TGs showed significant effects in reducing 24 h TUP [WMD = -0.84, 95 % CI (-1.09, -0.59)], elevating serum albumin [WMD = 2.88, 95 % CI (1.87, 3.90)], and the total efficiency [OR = 4.08, 95 % CI (2.37, 7.04)]. This effect was consistent across the subgroups of period of intervention. Conclusions The present research showed that TGs was significantly associated with improvement of renal function in patients with DN. TGs offers a novel approach to the treatment of DN, more high-quality RCTs are needed for a better understanding of the role of TGs in DN therapy.

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