Tripterygium Wilfordii Multiglycosides Combined with Prednisone in the Treatment of Idiopathic Membranous Nephropathy: A Protocol for a Systematic Review and Meta-analysis

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2020 Feb 1

PMID 32000425

Citations 8

Authors

Yuxia Jin

Jiayuan Zhang

Yunxia Wang

Xiao Xiao

Qi Zhang

Affiliations

Soon will be listed here.

Abstract

Aim: The aim of this review is to assess the efficacy and safety of tripterygium wilfordii multiglycosides combined with prednisone in the treatment of idiopathic membranous nephropathy.

Background: Tripterygium wilfordii multiglycosides, a Chinese patent medicine, is widely in-depth research in China, and is proved to have anti-inflammatory and immunosuppressive effect. It has been extensively used in China for the treatment of autoimmune diseases, such as idiopathic membranous nephropathy (IMN). However, there has no relevant systematic review studied on its effects and safety been reported. We plan to perform a systematically reviewing to assess the efficacy and safety of tripterygium wilfordii multiglycosides combined with hormones in the treatment of IMN.

Methods: Seven electronic databases will be searched to identify eligible trials. Randomized controlled trials (RCTs) that compared tripterygium wilfordii multiglycosides combined with prednisone versus standard therapy are included. Methodological quality is assessed using the Cochrane Collaboration Risk of Bias tool. A random- or fixed-effect model is used to analyze outcomes that are expressed as risk ratios (RRs) or mean differences (MD), and the I statistic is used to assess heterogeneity.

Results: A high-quality synthesis of current evidence of tripterygium wilfordii multiglycosides combined with prednisone in the treatment of idiopathic membranous nephropathy will be provided in this study.

Conclusion: This systematic review will provide evidence of whether tripterygium wilfordii multiglycosides is an effective intervention for idiopathic membranous nephropathy.PROSPERO registration number: No.CRD42018118179.

Citing Articles

Investigating potential drug targets for IgA nephropathy and membranous nephropathy through multi-queue plasma protein analysis: a Mendelian randomization study based on SMR and co-localization analysis.

Xu X, Miao C, Yang S, Xiao L, Gao Y, Wu F BioData Min. 2024; 17(1):49.

PMID: 39516845 PMC: 11545554. DOI: 10.1186/s13040-024-00405-w.

Moshen granule ameliorates membranous nephropathy by regulating NF-ƙB/Nrf2 pathways via aryl hydrocarbon receptor signalling.

Ma S, Li X, Duan T, Pei M, Zou L, Yu X Heliyon. 2023; 9(9):e20019.

PMID: 37809643 PMC: 10559749. DOI: 10.1016/j.heliyon.2023.e20019.

Efficacy and safety of Tripterygium wilfordii multiglucoside for idiopathic membranous nephropathy: a systematic review with bayesian meta-analysis.

Wang H, Liu H, Xue X, Wang Q, Yuan J Front Pharmacol. 2023; 14:1183499.

PMID: 37608889 PMC: 10442163. DOI: 10.3389/fphar.2023.1183499.

Screening of major hepatotoxic components of Tripterygium wilfordii based on hepatotoxic injury patterns.

Li M, Luo Q, Chen X, Qiu F, Tao Y, Sun X BMC Complement Med Ther. 2023; 23(1):9.

PMID: 36627617 PMC: 9830834. DOI: 10.1186/s12906-023-03836-w.

Membranous nephropathy: Systems biology-based novel mechanism and traditional Chinese medicine therapy.

Miao H, Zhang Y, Yu X, Zou L, Zhao Y Front Pharmacol. 2022; 13:969930.

PMID: 36176440 PMC: 9513429. DOI: 10.3389/fphar.2022.969930.

References

du Buf-Vereijken P, Branten A, Wetzels J . Cytotoxic therapy for membranous nephropathy and renal insufficiency: improved renal survival but high relapse rate. Nephrol Dial Transplant. 2004; 19(5):1142-8. DOI: 10.1093/ndt/gfh036. View

Polanco N, Gutierrez E, Rivera F, Castellanos I, Baltar J, Lorenzo D . Spontaneous remission of nephrotic syndrome in membranous nephropathy with chronic renal impairment. Nephrol Dial Transplant. 2011; 27(1):231-4. DOI: 10.1093/ndt/gfr285. View

Chen Y, Gong Z, Chen X, Tang L, Zhao X, Yuan Q . Tripterygium wilfordii Hook F (a traditional Chinese medicine) for primary nephrotic syndrome. Cochrane Database Syst Rev. 2013; (8):CD008568. DOI: 10.1002/14651858.CD008568.pub2. View

Begg C, Mazumdar M . Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994; 50(4):1088-101. View

Egger M, Davey Smith G, Schneider M, Minder C . Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997; 315(7109):629-34. PMC: 2127453. DOI: 10.1136/bmj.315.7109.629. View

Schieppati A, Mosconi L, Perna A, MECCA G, Bertani T, Garattini S . Prognosis of untreated patients with idiopathic membranous nephropathy. N Engl J Med. 1993; 329(2):85-9. DOI: 10.1056/NEJM199307083290203. View

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009; 62(10):e1-34. DOI: 10.1016/j.jclinepi.2009.06.006. View

van den Brand J, van Dijk P, Hofstra J, Wetzels J . Cancer risk after cyclophosphamide treatment in idiopathic membranous nephropathy. Clin J Am Soc Nephrol. 2014; 9(6):1066-73. PMC: 4046727. DOI: 10.2215/CJN.08880813. View

Chen B . Triptolide, a novel immunosuppressive and anti-inflammatory agent purified from a Chinese herb Tripterygium wilfordii Hook F. Leuk Lymphoma. 2001; 42(3):253-65. DOI: 10.3109/10428190109064582. View

10.

Xu G, Tu W, Jiang D, Xu C . Tripterygium wilfordii Hook F treatment for idiopathic refractory nephrotic syndrome in adults: a meta-analysis. Nephron Clin Pract. 2009; 111(4):c223-8. DOI: 10.1159/000208990. View

11.

Qiu T, Zhang C, Zhao H, Zhou J . Calcineurin inhibitors versus cyclophosphamide for idiopathic membranous nephropathy: A systematic review and meta-analysis of 21 clinical trials. Autoimmun Rev. 2016; 16(2):136-145. DOI: 10.1016/j.autrev.2016.12.005. View

12.

Wan Y, Sun W, Zhang J, Li M, Ruan J, Wang Y . [Nephritic model induced by anti-Thy1.1 monoclonal antibody and its application to study on Chinese materia medica]. Zhongguo Zhong Yao Za Zhi. 2007; 32(6):461-5. View

13.

Polanco N, Gutierrez E, Covarsi A, Ariza F, Carreno A, Vigil A . Spontaneous remission of nephrotic syndrome in idiopathic membranous nephropathy. J Am Soc Nephrol. 2010; 21(4):697-704. PMC: 2844306. DOI: 10.1681/ASN.2009080861. View

14.

Chen S . [Effect of Tripterygium wilfordii on the remission of proteinuria in patients with nephrotic syndrome]. Zhong Xi Yi Jie He Za Zhi. 1985; 5(3):164-6, 132. View

15.

Radhakrishnan J, Cattran D . The KDIGO practice guideline on glomerulonephritis: reading between the (guide)lines--application to the individual patient. Kidney Int. 2012; 82(8):840-56. DOI: 10.1038/ki.2012.280. View

16.

Hofstra J, Wetzels J . Alkylating agents in membranous nephropathy: efficacy proven beyond doubt. Nephrol Dial Transplant. 2010; 25(6):1760-6. DOI: 10.1093/ndt/gfq017. View

17.

Xu X, Li Q, Xia S, Wang M, Ji W . Tripterygium Glycosides for Treating Late-onset Rheumatoid Arthritis: A Systematic Review and Meta-analysis. Altern Ther Health Med. 2016; 22(6):32-39. View

18.

Jiang X . Clinical observations on the use of the Chinese herb Tripterygium wilfordii Hook for the treatment of nephrotic syndrome. Pediatr Nephrol. 1994; 8(3):343-4. DOI: 10.1007/BF00866356. View

19.

Tao X, Sun Y, Zhang N . [Treatment of rheumatoid arthritis with low doses of multi-glycosides of Tripterygium wilfordii]. Zhong Xi Yi Jie He Za Zhi. 1990; 10(5):289-91, 261-2. View

20.

Wang M, Huang J, Fan H, He D, Zhao S, Shu Y . Treatment of Rheumatoid Arthritis Using Combination of Methotrexate and Tripterygium Glycosides Tablets-A Quantitative Plasma Pharmacochemical and Pseudotargeted Metabolomic Approach. Front Pharmacol. 2018; 9:1051. PMC: 6189563. DOI: 10.3389/fphar.2018.01051. View