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SYSTEMATIC REVIEW article

Front. Pharmacol.
Sec. Pharmacoepidemiology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1440584
This article is part of the Research Topic Biologic Drugs in Immune-Mediated Inflammatory Diseases: Validation, Drug-Utilization, Effectiveness, Regulation, Costs, and Safety in the Real World View all 8 articles

A Systematic Review and Meta-analysis of the Efficacy and Safety of Iguratimod in the Treatment of Inflammatory Arthritis and Degenerative Arthritis

Provisionally accepted
Liuting Zeng Liuting Zeng 1Qi He Qi He 1Ying Deng Ying Deng 1*Kailin Yang Kailin Yang 2Junpeng Chen Junpeng Chen 1Yanfang Luo Yanfang Luo 1*Anqi Ge Anqi Ge 1*Xiaofei Zhu Xiaofei Zhu 1*Zhiyong Long Zhiyong Long 1*Wensa Hao Wensa Hao 1*Lingyun Sun Lingyun Sun 1*
  • 1 Peking Union Medical College Hospital (CAMS), Beijing, Beijing Municipality, China
  • 2 The First Hospital of Hunan University of Chinese Medicine, Changsha, China

The final, formatted version of the article will be published soon.

    Objective: To assess the efficacy and safety of iguratimod (IGU) in the treatment of inflammatory arthritis and degenerative arthritis Methods: Initially, randomized controlled trials (RCTs) on using IGU in treating inflammatory arthritis and degenerative arthritis were systematically gathered from various databases up to February 2024. Subsequently, two researchers independently screened the literature, extracted data, assessed the risk of bias in included studies, and conducted a meta-analysis using RevMan 5.4 software. Results: Fifty-four RCTs involving three inflammatory arthritis were included, including ankylosing spondylitis (AS), osteoarthritis (OA), and rheumatoid arthritis (RA). For AS, the meta-analysis results showed that IGU may decrease BASDAI (SMD -1.68 [-2.32, -1.03], P < 0.00001) and BASFI (WMD -1.29 [-1.47, -1.11], P < 0.00001); IGU may also decrease inflammatory factor [ESR: (WMD -10.33 [-14.96, -5.70], P < 0.0001); CRP: (WMD -10.11 [-14.55, -5.66], P < 0.00001); TNF-α: (WMD -6.22 [-7.97, -4.47], P <0.00001)]. For OA, the meta-analysis results showed that IGU may decrease VAS (WMD -2.20 [-2.38, -2.01], P < 0.00001) and WOMAC (WMD -7.27 [-12.31, -2.24], P = 0.005); IGU may also decrease IL-6 (WMD -8.72 [-10.00, -7.45], P < 0.00001). For RA, the meta-analysis results showed that IGU may improve RA remission rate [ACR20: (RR 1.18 [1.02, 1.35], P = 0.02); ACR50: (RR 1.32 [1.05, 1.64], P = 0.02); ACR70: (RR 1.44 [1.02, 2.04], P = 0.04)] and decrease DAS28 (WMD -0.92 [-1.20, -0.63], P < 0.00001); IGU may also decrease inflammatory factors [CRP: (SMD -1.36 [-1.75, -0.96], P < 0.00001); ESR: (WMD -9.09 [-11.80, -6.38], P < 0.00001); RF: (SMD -1.21 [-1.69, -0.73], P < 0.00001)]. Regarding safety, adding IGU will not increase the incidence of adverse events. Conclusion: IGU might emerge as a promising and secure therapeutic modality for addressing AS, OA, and RA.

    Keywords: Inflammatory arthritis, Iguratimod, Systematic review, Meta-analysis, Degenerative arthritis

    Received: 29 May 2024; Accepted: 26 Aug 2024.

    Copyright: © 2024 Zeng, He, Deng, Yang, Chen, Luo, Ge, Zhu, Long, Hao and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ying Deng, Peking Union Medical College Hospital (CAMS), Beijing, 100730, Beijing Municipality, China
    Yanfang Luo, Peking Union Medical College Hospital (CAMS), Beijing, 100730, Beijing Municipality, China
    Anqi Ge, Peking Union Medical College Hospital (CAMS), Beijing, 100730, Beijing Municipality, China
    Xiaofei Zhu, Peking Union Medical College Hospital (CAMS), Beijing, 100730, Beijing Municipality, China
    Zhiyong Long, Peking Union Medical College Hospital (CAMS), Beijing, 100730, Beijing Municipality, China
    Wensa Hao, Peking Union Medical College Hospital (CAMS), Beijing, 100730, Beijing Municipality, China
    Lingyun Sun, Peking Union Medical College Hospital (CAMS), Beijing, 100730, Beijing Municipality, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.