@article{20240,
  author = {Liyanage T. and Zhu B. and Cass Alan and Chen H. and Wang Y. and Wang A. and Jun M. and Jicheng L. and Jardine M and Perkovic Vlado},
  title = {Tripterygium Preparations for the Treatment of CKD: A Systematic Review and Meta-analysis},
  abstract = {<p>
BACKGROUND: Preparations of the herb Tripterygium wilfordii Hook F are used widely for the treatment of chronic kidney disease in China. The efficacy and safety of Tripterygium preparations still have not been fully identified. STUDY DESIGN: Systematic review and meta-analysis. SETTING &amp; POPULATION: Patients with chronic kidney disease. SELECTION CRITERIA FOR STUDIES: Randomized controlled trials. INTERVENTION: Tripterygium preparations (Tripterygium glycoside tablets, Tripterygium hypoglaucum Hutch tablets, and Tripterygium granules or extracts) versus placebo, standard care, or other immunosuppressive treatment. OUTCOMES: Weighted mean difference and summary estimates of relative risk (RR) reductions with 95% CIs were calculated with a random-effects model. Outcomes analyzed included change in proteinuria, serum creatinine level, and creatinine clearance rate, as well as remission and relapse rate and drug-related adverse events. RESULTS: We identified 75 trials that included 4,386 participants. Overall, Tripterygium therapy reduced proteinuria by protein excretion of 628 (95% CI, -736 to -521) mg/d and reduced serum creatinine level by 0.12 (95% CI, -0.17 to -0.06) mg/dL compared with controls (both P &lt; 0.001) in a range of kidney conditions. Tripterygium preparations also increased the rate of complete remission by 56% (95% CI, 32%-85%; P &lt; 0.001) and of complete or partial remission by 24% (95% CI, 17%-31%; P &lt; 0.001) while reducing relapse by 58% (95% CI, 42%-69%; P &lt; 0.001). Tripterygium preparations increased the rate of liver function test result abnormalities (RR, 4.03; 95% CI, 2.24-7.25; P &lt; 0.001) and altered menstruation (RR, 5.29; 95% CI, 2.09-13.38; P &lt; 0.001). LIMITATIONS: Suboptimal study quality, significant heterogeneity in the primary outcome. CONCLUSIONS: Tripterygium preparations may have nephroprotective effects, but high-quality trials are required to reliably determine the balance of benefits and harms.
</p>
},
  year = {2013},
  journal = {American Journal of Kidney Diseases},
  edition = {2013/05/15},
  isbn = {1523-6838 (Electronic)0272-6386 (Linking)},
  note = {Zhu, BinWang, YingJardine, MegJun, MinLv, Ji-ChengCass, AlanLiyanage, ThamindaChen, Hong-YuWang, Yong-JunPerkovic, VladoAm J Kidney Dis. 2013 May 9. pii: S0272-6386(13)00646-X. doi: 10.1053/j.ajkd.2013.02.374.},
  language = {Eng},
}