The effectiveness and safety of total glucosides of paeony in systemic lupus erythematosus: A systematic review and meta-analysis

Background: To evaluate the efficacy and safety of total glucosides of paeony in the treatment of systemic lupus erythematosus (SLE).

Methods: From the creation of the database to July 2021, multiple databases were searched for randomized controlled trials of treating SLE with total glucosides of paeony (TGP) combining chemical medicine. After screening, quality evaluation and data extraction, the included studies were analyzed by Revman5.3 software.

Results: A total of 11 studies were included, including 836 patients (treatment group 417, control group 419). Meta analysis showed that on the basis of routine treatment, TGP could further improve the treatment effective rate (OR = 4.19, 95% CI: 2.21 to 7.95, Z = 4.38, P < .0001), reduced SLE Disease Activity Index (SLEDAI) (MD = -1.70, 95%CI: -2.51 to -0.89, Z = 4.11, P < .0001) and erythrocyte sedimentation rate (MD = -7.04, 95%CI: -8.48 to -5.59, Z = 9.53, P < .00001), reduced the level of immunoglobulin A (IgA) (MD = -0.60, 95%CI: -0.82 to -0.37, Z = 5.24, P < .00001), immunoglobulin G (IgG) (MD = -2.97, 95%CI: -3.72 to -2.23, Z = 7.82, P < .00001), and immunoglobulin M (IgM) (MD = -0.36, 95%CI: -0.45 to -0.27, Z = 7.54, P < .00001), increased the level of complement C3 (MD = 0.34, 95%CI: 0.30 to 0.39, Z = 14.40, P < .00001) and complement C4 (MD = 0.07, 95%CI: 0.06 to 0.08, Z = 10.08, P < .00001), and decreased the recurrence (OR = 0.31, 95%CI: 0.16 to 0.61, Z = 3.39, P = .0007), and there was no significant difference in the incidence of adverse reactions (OR = 0.93, 95%CI: 0.45 to 1.91, Z = 0.20, P = .84).

Conclusion: On the basis of conventional treatment, the combined use of TGP can enhance the clinical efficacy of SLE without increasing the incidence of adverse effects.