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SYSTEMATIC REVIEW article

Front. Pharmacol.
Sec. Ethnopharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1493590
This article is part of the Research Topic Can Herbal Medicines and Their Metabolites Contribute to the Prevention and Treatment of Diabetic Kidney Disease (DKD) View all articles

Efficacy and safety of tripterygium glycosides combined with ACEI/ARB on diabetic nephropathy: a meta-analysis

Provisionally accepted
Zhuan'E Yao Zhuan'E Yao 1Pengbo Wang Pengbo Wang 1Qinjuan Fu Qinjuan Fu 1Qiong Song Qiong Song 1Haojian Xu Haojian Xu 1Peng Zhang Peng Zhang 2*
  • 1 Shaanxi Provincial Second People’s Hospital, Xi'an, Shaanxi, China
  • 2 Shaanxi Provincial People’s Hospital, Xian, China

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

    Aims:This study aims to evaluate the efficacy and safety of tripterygium glycosides (TG) combined with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARBs) in treating DN and provide high-level evidence to support its standardized application.Literatures were retrieved from PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, Wanfang and VIP databases, the search time frame was defined as from the time of establishment to April 2023. This study only included randomized controlled trials (RCTs) of tripterygium glycosides combined with ACEI/ARB in the treatment of diabetic nephropathy, and the final included studies were identified according to the inclusion and exclusion criteria, and meta-analysis of data was performed using RevMan 5.3 software.Results: A total of 44 RCTs with 3537 DN patients were included in the study. Compared with the control group, tripterygium glycosides combined with ACEI/ARB significantly reducing 24h-UTP (24h urine total protein) [SMD=-1.46, 95% CI (-1.70,-1.23), P<0.00001], increasing effective rate [RR=1.23, 95% CI (1.17,1.29), P<0.00001], elevating serum albumin [SMD=0.85, 95% CI (0.69,1.02), P<0.00001], improving serum creatinine [SMD=-0.35, 95% CI (-0.59,-0.11), P=0.004], with no difference in BUN (blood urea nitrogen) [SMD=-0.17, 95% CI (-0.48,0.13), P=0.27],the adverse reactions rate was higher than those of the control group [RR=1.96, 95%CI (1.43, 2.68), P<0.0001].This study showed that the combination of tripterygium glycosides and ACEI/ARB was more effective than ACEI/ARB alone.However, the side effects of the combined treatment group were higher than those of the control group, especially liver function damage, which also suggested that its safety in the treatment of diabetic nephropathy was worth considering. Therefore, although tripterygium glycosides provided a choice for the clinical treatment of diabetic nephropathy, its side effects limited its clinical application.In future studies, we need to further optimize tripterygium glycosides and reduce its side effects to ensure the safety of clinical application.

    Keywords: diabetic nephropathy, Tripterygium glycosides, ACEI/ARB, Meta-analysis, efficacy

    Received: 09 Sep 2024; Accepted: 31 Dec 2024.

    Copyright: © 2024 Yao, Wang, Fu, Song, Xu and Zhang. 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: Peng Zhang, Shaanxi Provincial People’s Hospital, Xian, China

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