Clinical efficacy and safety of tripterygium glycosides in treatment of stage IV
diabetic nephropathy: A meta-analysis
#MMPMID28352854
Hong Y
; Gui Z
; Cai X
; Lan L
Open Med (Wars)
2016[]; 11
(1
): 611-617
PMID28352854
show ga
The aim of this meta-analysis was to evaluate the clinical efficacy and safety of
tripterygium glycosides in treatment of stage IV diabetic nephropathy. Methods
Through searching the PubMed and CNKI databases, the open published clinically
controlled trials related to efficacy and safety of tripterygium glycosides in
the treatment of stage IV diabetic nephropathy were collected. The pooled total
efficacy, 24h urinary protein, serum creatinine and tripterygium glycosides
related toxicity were calculated using Stata 11.0 software. Results Fourteen
publications including 992 subjects (512 in the experimental group and 480 in the
control group) were included in this study. Eight studies reported the total
clinical efficacy comparing the experiment and control groups. No significant
statistical heterogeneity was found in total efficacy (I(2)=24.9%, p>0.05). Thus,
the combined odds ratio (OR) was pooled by fixed effect model. The pooled OR=4.16
with its 95% CI 2.71~6.37 (p<0.05), which indicated the total efficacy in the
experiment group, was significant higher than that of control group (p<0.05);
Thirteen studies reported the post-treatment 24h urinary protein value.
Statistical heterogeneity analysis indicated significant heterogeneity across
studies (I(2)=91.1%, p<0.05); that data was pooled by a random effects model. The
combined standardized mean difference (SMD) was -1.55 with its 95% I -2.06~1.03,
(p<0.05). The results indicated that post-treatment 24h urinary protein in the
experiment group was significant lower than that in control group (p<0.05); Ten
studies reported the post-treatment serum creatinine. Significant heterogeneity
existed across those studies (I(2)=82.3%, p<0.05). Thereafter, the data was
pooled by a random effect model. The combined standardized mean difference (SMD)
was -0.24 with its 95%CI -0.40~0.09, (p<0.05). The results indicated that the
post-treatment serum creatinine in experiment group was significant lower than
that of control group (p<0.05); Eight studies reported tripterygium
glycoside-associated toxicity such as liver function damage, gastrointestinal
reactions and menstrual disorders. With no statistical heterogeneity among the
studies, the data was pooled by fixed effect model. The pooled OR=6.42 (95%CI
2.23~18.48, p<0.05). The pooled results showed the tripterygium glycoside-
associated toxicity incidence rate was significant higher in the experiment group
than that of the control group (p<0.05); There were no publication bias for
effect size of total efficacy, 24h urinary protein, and serum creatinine.
However, for tripterygium glycoside-related toxicity, the publication bias was
significant (t=-3.55, p<0.05). Conclusion The present evidence shows that
tripterygium glycosides can improve clinical efficacy, reduce the 24h urinary
protein and serum creatinine, but that they increase the tripterygium
glycoside-related toxicity in treatment of stage IV diabetic nephropathy.
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