Efficacy and safety of tetrandrine in treatment of rheumatoid arthritis: a meta analysis.

OBJECTIVES To explore the efficacy and safety of tetrandrine in the treatment of rheumatoid arthritis. METHODS Randomized controlled studies of tetrandrine in the treatment of rheumatoid arthritis were searched in China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), World Wide Web Database, SinoMed, PubMed, Springer, Web of Science, the Cochrane Central Register of Controlled Trails database. A meta-analysis was conducted using R software version 3.5.3 to evaluate the clinical outcomes, including the total effective rate, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), visual analog scale (VAS) for pain, disease activity score (DAS), tender joint count (TJC), swollen joint count (SJC), and morning stiffness duration, as well as adverse events of RA patients. RESULTS A total of 10 articles were included in the study. The meta-analysis indicated that tetrandrine significantly improved the total effective rate (OR=3.27, 95%CI: 2.01-5.37, P<0.01), ESR (SMD=1.12, 95%CI: 0.06-2.19, P<0.05), CRP (SMD=0.75, 95%CI: 0.28-1.22, P<0.01), VAS (SMD=0.55, 95%CI: 0.21-0.89, P<0.01), SJC (SMD=0.85, 95%CI: 0.40-1.31, P<0.01), TJC (SMD=1.16, 95%CI: 0.58-1.74, P<0.01), and morning stiffness (SMD=1.09, 95%CI: 0.68-1.50, P<0.01). However, no statistical significance was found in RF (SMD=1.70, 95%CI: －1.10-4.51, P>0.05) and DAS (SMD=0.26, 95%CI: －0.59-1.11, P>0.05). The overall incidence of adverse events associated with tetrandrine treatment for rheumatoid arthritis was 20% (95%CI: 12%-27%, I2=60%, P<0.05), with mild severity and favorable outcomes. CONCLUSIONS Tetrandrine is effective in the treatment of RA patients with a mild degree of adverse events.