Evidence map›Paper›PMID 40717986›Full record

SynthesisFrontiers in pharmacology2025

Efficacy of Tripterygium glycosides in immune-mediated kidney diseases as a immunomodulation drug in combination with conventional immunosuppressive agents: a systematic review and meta-analysis of randomized controlled trials.

Yaotan Li, Jinyi Hou, Xiaochang Wu, Chang Liu, Mengqi Zhou, Shijia Lin, Weijing Liu, Yaoxian Wang, Huijuan Zheng

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yaotan Li *Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.
Jinyi Hou *Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.
Xiaochang WuDongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.
Chang LiuBeijing University of Chinese Medicine, Beijing, China.
Mengqi ZhouBeijing Puren Hospital, Beijing, China.
Shijia LinDongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.
Weijing LiuDongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.
Yaoxian WangRenal Research Institution of Beijing University of Chinese Medicine, Beijing, China.
Huijuan ZhengDongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Immune-mediated kidney diseases involve the immune system attacking the kidneys, resulting in damage and dysfunction. Tripterygium glycosides (TG) are known for their strong immunosuppressive and anti-inflammatory effects and are commonly used alongside traditional immunosuppressive agents. However, evidence-based support for the combined use of these treatments in immune-mediated kidney diseases remains insufficient and requires further validation. Purpose: The aim of this study is to evaluate the efficacy and safety of TG combined with immunosuppressive agents in the treatment of immune-mediated kidney diseases. Study design: Systematic Review and Meta-Analysis of Randomized Controlled Trials (RCTs). Methods: We searched nine electronic databases for articles from 1 January 2014 to 1 June 2025. We included the RCTs comparing TG combined with immunosuppressive agents versus immunosuppressive agents alone. Meta-analysis was performed according to the Cochrane Handbook. Results: Thirty-six RCTs were included, involving 3,455 patients with various conditions such as membranous nephropathy (MN), IgA nephropathy (IgAN), primary nephrotic syndrome (PNS) and others. The combined use of TG and immunosuppressive agents differs from the use of immunosuppressive agents alone in terms of clinical efficacy (RR = 1.26; 95%CI: 1.22-1.30), improvement in serum creatinine (Cr) (SMD = -0.86; 95%CI: -1.11 to -0.61), blood urea nitrogen (BUN) (SMD = -0.68; 95%CI: -1.05 to -0.31), 24-h urinary total protein (24h-UTP) (SMD = -0.93; 95%CI: -1.13 to -0.74), and serum albumin (ALB) (SMD = 1.30; 95%CI: 1.08-1.52). However, there is no statistically significant difference in the improvement of total cholesterol (TC) (SMD = -0.62; 95%CI: -1.39 to 0.16). In terms of overall safety, the combination therapy shows a statistically significant difference compared to the use of immunosuppressive agents alone (RR = 0.72; 95%CI: 0.58-0.90), but no differences were observed in gastrointestinal issues, liver damage, leukopenia, and infections. Additionally, our analysis found that the combination therapy has a significant advantage over the use of immunosuppressive agents alone in reducing the recurrence rate (RR = 0.21; 95%CI: 0.10-0.44). In terms of mechanisms, the final results indicate that there are differences in interleukin-6 (IL-6) and C-reactive protein (CRP) levels between the two groups, while no differences were observed in interleukin-1 (IL-1) and tumor necrosis factor (TNF-α). However, treatment course, TG dosage, and sample size are important factors influencing the results. Conclusion: Our study suggests that the combination of TG with immunosuppressive agents offers more pronounced efficacy in treating immune mediated kidney diseases, without increasing the incidence of adverse reactions. However, our findings may be limited by the quality of the existing studies. High-quality RCTs are needed to provide more accurate evidence. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023473530.

Indexed as

immune-mediated kidney diseasesimmunosuppressive agentsmeta-analysisrandomized controlled trialsTripterygium glycosides

Identifiers

PMID40717986
PMCPMC12289580

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.