Methotrexate and Tripterygium wilfordii combination for rheumatoid arthritis

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Methotrexate and Tripterygium wilfordii combination for rheumatoid arthritis

For several decades, the extracts of Tripterygium wilfordii Hook F or TwHF (a traditional Chinese herbal medicine) and methotrexate (MTX) have been used for rheumatoid arthritis (RA) treatment in China. However,  the efficacy and safety of MTX and TwHF treatment are debatable.

A comprehensive search of databases in both Chinese and English was executed by Wang X and colleagues. Two authors independently extracted and investigated the data from the selected studies.

A total of 643 patients participated in six randomized controlled trials incorporated in the final analysis. TwHF (in the form of Tripterygium glycosides) was added to the MTX-based therapy in all the trials.

For efficacy, the addition of TwHF increased 50% responder rates (RR) (RR 1.337, 95% confidence interval [CI]: 1.188-1.505, p<0.001), and it lowered swollen and tender joint counts, shortened the duration of morning stiffness, decreased the erythrocyte sedimentation rate and decreased the level of C-reactive protein and rheumatoid factor. For safety, the addition of TwHF did not augment the rate of adverse events (RR 0.824, 95% CI: 0.635-1.068, p=0.143).

Thus, it can be concluded that MTX plus TwHF therapy may be a more effective and similar safe strategy for rheumatoid arthritis management as compared to MTX monotherapy. Although, further large clinical trials to investigate the TwHF add-on therapy were permitted.


Life Sci.

Link to the source:

The original title of the article:

Treatment of rheumatoid arthritis with combination of methotrexate and Tripterygium wilfordii: A meta-analysis


Wang X et al.

Therapeutic, Methotrexate (MTX), Tripterygium wilfordii, Rheumatoid Arthritis (RA), Joints, Antimetabolites, Randomized controlled trial, Efficacy, Safety
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