Comparative efficacy, safety and cost of oral Chinese patent medicines for rheumatoid arthritis: a Bayesian network meta-analysis
Comparative efficacy, safety and cost of oral Chinese patent medicines for rheumatoid arthritis: a Bayesian network meta-analysis
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口服中成药治疗类风湿性关节炎的疗效、安全性和成本比较：贝叶斯网络荟萃分析
DOI：
10.1186/s12906-020-03004-4
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发表时间：
2020-07
影响因子：
3.9
通讯作者：
Zhi-jian Lin
中科院分区：
文献类型：
--
作者：
Dan Zhang;Jin-tao Lyu;Bing Zhang;Xiao-meng Zhang;Hao Jiang;Zhi-jian Lin
研究背景类风湿性关节炎（RA）是一种常见的炎症性疾病，给全球社会和经济带来沉重负担。中成药（CPM）作为替代疗法受到关注，因为它可以通过整体调节发挥令人满意的治疗效果。目前，几种口服中成药被常规推荐用于治疗RA。因此，我们进行了网络荟萃分析（NMA），试图通过评估针对同一疾病的多种干预措施的比较效果来综合决策证据，根据其临床治疗效果和症状缓解、安全性和每日成本来确定最佳干预措施。方法综合检索3个国外数据库和4个中国数据库中关于CPM治疗RA的随机对照试验（RCT），检索结果最后更新于1月10日。 2019.所选试验的偏倚由两个人通过 RoB2 独立评估。在荟萃分析过程中采用随机效应模型，并利用 Stata 14.1 和 WinBUGS 1.4.3 软件以比值比 (OR)、平均差 (MD) 和 95% 可信区间 (CI) 评估有关疗效和安全性的结果。此外，还对口服CPM的疗效、安全性和成本的比较进行了聚类分析和综合调查。结果涉及10,213名受试者的116个RCT符合纳入标准并被纳入当前的NMA。现有证据的结果表明，痹芪胶囊和瘀血痹胶囊在考虑益处、耐受性和日常费用方面可能具有良好的平衡。此外，作为最便宜的选择，雷公藤多甙片对 RA 患者有缓解关节压痛、关节肿胀和晨僵的趋势。结论 痹芪胶囊、愈血痹胶囊和雷公藤多甙片在临床疗效和症状方面均具有良好的疗效，被推荐用于治疗 RA，同时，它们在安全性和日常使用方面可能是更耐受和可接受的治疗方案。成本。尽管如此，高质量、多中心和头对头试验的额外结果对于支持我们的研究结果至关重要。
BackgroundRheumatoid arthritis (RA) is a common inflammatory disease with a substantial burden for society and economic worldwide. Chinese patent medicines (CPMs) have gained attention as alternative remedies due to they can exert the satisfactory therapeutic effects via holistic regulation. Currently, several oral Chinese patent medicines are routinely recommended for managing and treating RA. Therefore, a network meta-analysis (NMA), which tries to synthesize evidences for a decision making by evaluating the comparative effectiveness of multiple interventions against the same disease, was undertaken to identify the optimal intervention according to their efficacy in clinical treatment and symptom remission, safety profile and daily cost.MethodsRandomized controlled trials (RCTs) regarding CPMs to treat RA were comprehensive retrieved from 3 foreign databases and 4 Chinese databases, and the retrieved results were last updated on January 10, 2019. The bias of the selected trials was assessed by two individuals independently through RoB2. A random-effects model was adopted during the meta-analytic procedures, and outcomes concerning efficacy and safety were evaluated as odds ratios (OR), mean differences (MD) and 95% credible intervals (CI) utilizing Stata 14.1 and WinBUGS 1.4.3 software. Furthermore, the cluster analysis and comprehensive investigation were preformed concerning the comparative efficacy, safety and cost of oral CPMs.ResultsOne hundred sixteen RCTs involving 10,213 individuals met the inclusion criteria and were enrolled into current NMA. The results from existing evidence indicated that Biqi capsule and Yuxuebi capsule probably had a favorable balance in consideration of benefits, tolerability and daily cost. Furthermore, as the least expensive choice, glucosides of Tripterygium Wilfordii tablet was associated with displaying a trend of relieving joint tenderness, joint swelling, and morning stiffness for patients with RA.ConclusionBiqi capsule, Yuxuebi capsule and glucosides of Tripterygium Wilfordii tablet were recommended for treating RA based on the favorable benefits in both clinical efficacy and symptoms, and they, meanwhile, might be associated with the more tolerable and acceptable therapeutic alternative in terms of safety profile and daily cost. Nevertheless, the additional results from high-quality, multi-center and head-to-head trials would be pivotal for supporting our findings.
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影响因子：
5.3
作者：
通讯作者：
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影响因子：
3.7
作者：
F. Ferro;E. Elefante;N. Luciano;R. Talarico;M. Todoerti
通讯作者：
F. Ferro;E. Elefante;N. Luciano;R. Talarico;M. Todoerti
影响因子：
4
作者：
Krahn U;Binder H;König J
通讯作者：
König J
影响因子：
2.9
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Veroniki AA;Soobiah C;Tricco AC;Elliott MJ;Straus SE
通讯作者：
Straus SE
影响因子：
39.2
作者：
Hutton, Brian;Salanti, Georgia;Moher, David
通讯作者：
Moher, David