Protective Effect and Possible Mechanisms of Tripterygium Glycosides in Patients with Ankylosing Spondylitis: A Systematic Review and Meta-Analysis

OBJECTIVE: The safety and efficacy of Tripterygium glycosides (TG) were assessed for ankylosing spondylitis (AS) in accordance with the existing literatures. MATERIALS AND METHODS: Electronic literature was searched from Chinese VIP databases, Cochrane Library, Chinese Biomedical Literature Database, Wanfang Web of Science, EMBASE, Chinese National Knowledge Infrastructure, and the PubMed for the studies with the publication from the beginning to December 2021. Randomized controlled trials (RCTs) were included only. The major variables of result comprised erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Spinal Pain Visual Analog Score (SP-VAS), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Moreover, the secondary variables of result covered the overall clinical effective rate following the adverse drug reaction (ADR). We carried out the meta-analysis with the use of STATA 12.0 and RevMan 5.3. We used GRADE pro3.6.1 software to assess the quality of evidence. RESULTS: In general, we covered 15 randomized controlled trials with the focus of 1186 patients. As proven by our meta-analysis, TG as adjuvant therapy or monotherapy decreased the BASDAI, BASFI, SP-VAS, serum CRP, and ESR than control in patients suffering from AS. Additionally, TG treatment visibly improved the overall effective rate in AS. Nevertheless, TG was not found to significantly increase the rate of ADR in contrast to the control. CONCLUSION: As indicated by our result, TG may be an option to treat AS. In this paper, we recommended strict trials with high quality and large samples sizes for confirming the finding here.