Ophiocordyceps sinensis preparations combined with the renin–angiotensin system inhibitor for diabetic kidney disease treatment: an umbrella review of systematic reviews and network meta-analysis
Aims:This study aimed to synthesize the evidence of the comparative effectiveness and safety of Ophiocordyceps sinensis (OS) preparations combined with renin–angiotensin system inhibitors (RASi) for diabetic kidney disease (DKD).Methods:Eight databases were searched from their inception to May 2023....
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1360633/full |
| _version_ | 1827276783685206016 |
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| author | Xue Xue Xin-Yan Jin Xing-Lan Ye Ke-Ying Li Jia-Xuan Li Xue-Han Liu Juan Bai Qiang Liu Bing-Rui Zhang Xin-Rong Zou Jun Yuan Chun-Li Lu Fang-Fang Zhao Jian-Ping Liu Xiao-Qin Wang |
| author_facet | Xue Xue Xin-Yan Jin Xing-Lan Ye Ke-Ying Li Jia-Xuan Li Xue-Han Liu Juan Bai Qiang Liu Bing-Rui Zhang Xin-Rong Zou Jun Yuan Chun-Li Lu Fang-Fang Zhao Jian-Ping Liu Xiao-Qin Wang |
| author_sort | Xue Xue |
| collection | DOAJ |
| description | Aims:This study aimed to synthesize the evidence of the comparative effectiveness and safety of Ophiocordyceps sinensis (OS) preparations combined with renin–angiotensin system inhibitors (RASi) for diabetic kidney disease (DKD).Methods:Eight databases were searched from their inception to May 2023. Systematic reviews (SRs) of OS preparations combined with RASi for DKD were identified. Randomized controlled trials (RCTs) from the included SRs and additional searching were performed for data pooling. Cochrane risk-of-bias 2 (RoB 2) tool and AMSTAR 2 were used to evaluate the methodological quality of RCTs and SRs, respectively. A Bayesian network meta-analysis was performed to compare the add-on effect and safety of OS preparations for DKD. The certainty of evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.Results:Fourteen SRs were included, whose methodological quality was assessed as high (1/14) or critically low (13/14). After combining additional searching, 157 RCTs were included, involving 13,143 participants. The quality of the RCTs showed some concerns (155/157) or high risk (2/157). Jinshuibao capsules and tablets, Bailing capsules and tablets, and Zhiling capsules were evaluated. Compared to RASi, adding either of the OS capsular preparations resulted in a decreased 24-h urinary total protein levels. OS preparations ranked differently in each outcome. Jinshuibao capsules plus RASi were beneficial in reducing urinary protein, serum creatinine, serum urea nitrogen, and blood glucose levels, with moderate-certainty evidence. No serious adverse events were observed after adding OS to RASi.Conclusion:Combining OS capsular preparations with RASi appeared to be associated with decreased urinary total protein levels in DKD patients. Further high-quality studies are needed to confirm.Systematic Review Registration:INPASY202350066. |
| first_indexed | 2024-04-24T07:05:34Z |
| format | Article |
| id | doaj.art-9899a911ed7f4b99ac52e8c4c679f06c |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-24T07:05:34Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-9899a911ed7f4b99ac52e8c4c679f06c2024-04-22T04:21:24ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122024-04-011510.3389/fphar.2024.13606331360633Ophiocordyceps sinensis preparations combined with the renin–angiotensin system inhibitor for diabetic kidney disease treatment: an umbrella review of systematic reviews and network meta-analysisXue Xue0Xin-Yan Jin1Xing-Lan Ye2Ke-Ying Li3Jia-Xuan Li4Xue-Han Liu5Juan Bai6Qiang Liu7Bing-Rui Zhang8Xin-Rong Zou9Jun Yuan10Chun-Li Lu11Fang-Fang Zhao12Jian-Ping Liu13Xiao-Qin Wang14Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaSchool of Clinical Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, ChinaSchool of Clinical Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, ChinaSchool of Clinical Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaSchool of Clinical Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, ChinaHubei Key Laboratory of Theory and Application Research of Liver and Kidney in Traditional Chinese Medicine, Affiliated Hospital of Hubei University of Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, ChinaDongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaHubei Key Laboratory of Theory and Application Research of Liver and Kidney in Traditional Chinese Medicine, Affiliated Hospital of Hubei University of Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, ChinaDepartment of Nephrology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, ChinaTraditional Chinese Medicine Research Institute, Guangdong Pharmaceutical University, Guangzhou, ChinaXiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaHubei Key Laboratory of Theory and Application Research of Liver and Kidney in Traditional Chinese Medicine, Affiliated Hospital of Hubei University of Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, ChinaAims:This study aimed to synthesize the evidence of the comparative effectiveness and safety of Ophiocordyceps sinensis (OS) preparations combined with renin–angiotensin system inhibitors (RASi) for diabetic kidney disease (DKD).Methods:Eight databases were searched from their inception to May 2023. Systematic reviews (SRs) of OS preparations combined with RASi for DKD were identified. Randomized controlled trials (RCTs) from the included SRs and additional searching were performed for data pooling. Cochrane risk-of-bias 2 (RoB 2) tool and AMSTAR 2 were used to evaluate the methodological quality of RCTs and SRs, respectively. A Bayesian network meta-analysis was performed to compare the add-on effect and safety of OS preparations for DKD. The certainty of evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.Results:Fourteen SRs were included, whose methodological quality was assessed as high (1/14) or critically low (13/14). After combining additional searching, 157 RCTs were included, involving 13,143 participants. The quality of the RCTs showed some concerns (155/157) or high risk (2/157). Jinshuibao capsules and tablets, Bailing capsules and tablets, and Zhiling capsules were evaluated. Compared to RASi, adding either of the OS capsular preparations resulted in a decreased 24-h urinary total protein levels. OS preparations ranked differently in each outcome. Jinshuibao capsules plus RASi were beneficial in reducing urinary protein, serum creatinine, serum urea nitrogen, and blood glucose levels, with moderate-certainty evidence. No serious adverse events were observed after adding OS to RASi.Conclusion:Combining OS capsular preparations with RASi appeared to be associated with decreased urinary total protein levels in DKD patients. Further high-quality studies are needed to confirm.Systematic Review Registration:INPASY202350066.https://www.frontiersin.org/articles/10.3389/fphar.2024.1360633/fulldiabetic kidney diseaseOphiocordyceps sinensis preparationsrenin–angiotensin system inhibitorumbrella reviewnetwork meta-analysis |
| spellingShingle | Xue Xue Xin-Yan Jin Xing-Lan Ye Ke-Ying Li Jia-Xuan Li Xue-Han Liu Juan Bai Qiang Liu Bing-Rui Zhang Xin-Rong Zou Jun Yuan Chun-Li Lu Fang-Fang Zhao Jian-Ping Liu Xiao-Qin Wang Ophiocordyceps sinensis preparations combined with the renin–angiotensin system inhibitor for diabetic kidney disease treatment: an umbrella review of systematic reviews and network meta-analysis Frontiers in Pharmacology diabetic kidney disease Ophiocordyceps sinensis preparations renin–angiotensin system inhibitor umbrella review network meta-analysis |
| title | Ophiocordyceps sinensis preparations combined with the renin–angiotensin system inhibitor for diabetic kidney disease treatment: an umbrella review of systematic reviews and network meta-analysis |
| title_full | Ophiocordyceps sinensis preparations combined with the renin–angiotensin system inhibitor for diabetic kidney disease treatment: an umbrella review of systematic reviews and network meta-analysis |
| title_fullStr | Ophiocordyceps sinensis preparations combined with the renin–angiotensin system inhibitor for diabetic kidney disease treatment: an umbrella review of systematic reviews and network meta-analysis |
| title_full_unstemmed | Ophiocordyceps sinensis preparations combined with the renin–angiotensin system inhibitor for diabetic kidney disease treatment: an umbrella review of systematic reviews and network meta-analysis |
| title_short | Ophiocordyceps sinensis preparations combined with the renin–angiotensin system inhibitor for diabetic kidney disease treatment: an umbrella review of systematic reviews and network meta-analysis |
| title_sort | ophiocordyceps sinensis preparations combined with the renin angiotensin system inhibitor for diabetic kidney disease treatment an umbrella review of systematic reviews and network meta analysis |
| topic | diabetic kidney disease Ophiocordyceps sinensis preparations renin–angiotensin system inhibitor umbrella review network meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1360633/full |
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