Tripterygium Wilfordii Hook F For IgA Nephropathy:a Meta-analysis

Objective To assess the effect and safety of Tripterygium wilfordii Hook F (TwHF) in treatment of IgA nephropathy in adult by Meta analysis.Methods Cochrane Library (Issue 4,2014), PubMed, EMbase.Chinese biomedical literature database (CBM), China journal full text database (CNKI),VIP and Wanfang medicine database retrieval system were used to select literatures based on the age (established year-2004.4.28) and extract data by 2 investigator according to the criteria. The methodology of the research was assessed before analyzing all data by RevMan 5 software (version 5.2).Results A total of 11 RCTs involving 616 patients were included in the study. The results of meta-analyses based on stratified therapeutic strategies showed:a)Tripterygium wilfordii group has a better outcome compared with the MMF group,significant differences were found in the complete remission (CR) [OR=2.01,95%CI(1.04,3.87), P=0.04],serum albumin[MD=-6.42, 95%CI(-9.13,-3.71), P< 0.00001],total remission (TR)[OR=3.17,95%CI(1.22,8.23), P=0.02],and decrease of Protein Quantitation[MD=2.61,95%C1(1.34,3.88), P<0.0001];b) Tripterygium wilfordii group has a better outcome compared with the ACEI(ARB) group,significant differences were found in the complete remission (CR) [OR=4.40,95%CI(2.69, 7.21), P<0.00001],protein quantitation[MD=0.89,95%CI(0.56,1.22), P<0.0001], serum albumin[MD=-5.18,95%CI(-9.30,-1.05), P=0.01]and total remission (TR)[OR=4.23, 95%CI(2.34,7.65), P<0.00001];c) Tripterygium wilfordii group has a better outcome compared with the LEF group,significant differences were found in the total remission (TR) [OR=23.87, 95%CI(1.31,436.18), P=0.03];d) Tripterygium wilfordii group has no better outcome compared with the DXM group,significant differences were not found in the complete remission (CR) and total remission (TR).There were no significant difference between tripterygium wilfordii group and other groups in terms of the probability of adverse reactions and decrease of serum creatinine levels.Conclusion TwHF has favourable therapeutic effect and safety in treatment of IgAN. But its curative effect and more comprehensive safety still needs to be further verified by more large sample and high quality RCTs.