Efficacy and safety of Tripterygium wilfordii polyglycosides for diabetic kidney disease: an overview of systematic reviews and meta-analyses

Abstract Background Recently, several systematic reviews (SRs) and meta-analyses (MAs) of Tripterygium wilfordii polyglycoside (TWP) have reported significant benefits on diabetic kidney disease (DKD). However, the adoption of TWP for DKD remains uncommon. This study aimed to evaluate and summarize...

Full description

Bibliographic Details
Main Authors: Ying Wang, Mei Han, Yao-Tan Li, Zhen Wang, Jian-Ping Liu
Format: Article
Language:English
Published: BMC 2022-10-01
Series:Systematic Reviews
Subjects:
Online Access:https://doi.org/10.1186/s13643-022-02091-3
_version_ 1811250058323034112
author Ying Wang
Mei Han
Yao-Tan Li
Zhen Wang
Jian-Ping Liu
author_facet Ying Wang
Mei Han
Yao-Tan Li
Zhen Wang
Jian-Ping Liu
author_sort Ying Wang
collection DOAJ
description Abstract Background Recently, several systematic reviews (SRs) and meta-analyses (MAs) of Tripterygium wilfordii polyglycoside (TWP) have reported significant benefits on diabetic kidney disease (DKD). However, the adoption of TWP for DKD remains uncommon. This study aimed to evaluate and summarize the current evidence on TWP for DKD. Methods We searched PubMed, Web of Science, SINOMED, Embase, Cochrane Library, CNKI database, Wan Fang database, and VIP database, up to June 4, 2022. SRs of TWP on DKD were included. Two authors independently assessed eligibility, extracted data, and graded the quality of evidence. We appraised the reporting and methodological quality of the included studies based on the PRISMA statement and AMSTAR 2. Results We included 19 SRs and MAs. Seventeen MAs of proteinuria were identified; all suggested TWP exhibited anti-proteinuria function on DKD. Of these, only 2 were graded as moderate quality of evidence. Eighteen MAs estimated the reno-protective effect of TWP; nine of them showed that TWP improved renal function, including 2 MAs rated as moderate quality of evidence. Eleven SRs showed the serum albumin level was elevated in the TWP group. Of those, four were rated as moderate quality of evidence. Fourteen MAs of the incidence of adverse events were included. Twelve MAs indicated TWP increased the risk of adverse events, of which 4 were graded with moderate quality of evidence. Twenty of the 27 items in the PRISMA checklist were adequately reported with more than 75% compliance among the included SRs, while five of the 12 items in the PRISMA checklist for abstract were found to have less than 50% compliance. The overall reporting quality of SRs published in English was higher than that in Chinese. The methodological quality of the included SRs appraised by AMSTAR-2 ranged from critically low to moderate. Conclusion TWP appears effective for DKD on improving proteinuria and increasing the level of serum albumin, accompanied by a higher risk of adverse events. The evidence would be more credible and valuable to guide decision if the quality of the SRs and primary studies is improved. Systematic review registration PROSPERO CRD42021249560
first_indexed 2024-04-12T15:58:31Z
format Article
id doaj.art-a8d85af1dfce4a4180aaf39340276182
institution Directory Open Access Journal
issn 2046-4053
language English
last_indexed 2024-04-12T15:58:31Z
publishDate 2022-10-01
publisher BMC
record_format Article
series Systematic Reviews
spelling doaj.art-a8d85af1dfce4a4180aaf393402761822022-12-22T03:26:17ZengBMCSystematic Reviews2046-40532022-10-0111111410.1186/s13643-022-02091-3Efficacy and safety of Tripterygium wilfordii polyglycosides for diabetic kidney disease: an overview of systematic reviews and meta-analysesYing Wang0Mei Han1Yao-Tan Li2Zhen Wang3Jian-Ping Liu4Department of Nephrology, Dongzhimen Hospital, Beijing University of Chinese MedicineCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese MedicineDepartment of Nephrology, Dongzhimen Hospital, Beijing University of Chinese MedicineDepartment of Nephrology, Dongzhimen Hospital, Beijing University of Chinese MedicineCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese MedicineAbstract Background Recently, several systematic reviews (SRs) and meta-analyses (MAs) of Tripterygium wilfordii polyglycoside (TWP) have reported significant benefits on diabetic kidney disease (DKD). However, the adoption of TWP for DKD remains uncommon. This study aimed to evaluate and summarize the current evidence on TWP for DKD. Methods We searched PubMed, Web of Science, SINOMED, Embase, Cochrane Library, CNKI database, Wan Fang database, and VIP database, up to June 4, 2022. SRs of TWP on DKD were included. Two authors independently assessed eligibility, extracted data, and graded the quality of evidence. We appraised the reporting and methodological quality of the included studies based on the PRISMA statement and AMSTAR 2. Results We included 19 SRs and MAs. Seventeen MAs of proteinuria were identified; all suggested TWP exhibited anti-proteinuria function on DKD. Of these, only 2 were graded as moderate quality of evidence. Eighteen MAs estimated the reno-protective effect of TWP; nine of them showed that TWP improved renal function, including 2 MAs rated as moderate quality of evidence. Eleven SRs showed the serum albumin level was elevated in the TWP group. Of those, four were rated as moderate quality of evidence. Fourteen MAs of the incidence of adverse events were included. Twelve MAs indicated TWP increased the risk of adverse events, of which 4 were graded with moderate quality of evidence. Twenty of the 27 items in the PRISMA checklist were adequately reported with more than 75% compliance among the included SRs, while five of the 12 items in the PRISMA checklist for abstract were found to have less than 50% compliance. The overall reporting quality of SRs published in English was higher than that in Chinese. The methodological quality of the included SRs appraised by AMSTAR-2 ranged from critically low to moderate. Conclusion TWP appears effective for DKD on improving proteinuria and increasing the level of serum albumin, accompanied by a higher risk of adverse events. The evidence would be more credible and valuable to guide decision if the quality of the SRs and primary studies is improved. Systematic review registration PROSPERO CRD42021249560https://doi.org/10.1186/s13643-022-02091-3Diabetic kidney diseaseTripterygium wilfordii polyglycosideSystematic reviewOverview
spellingShingle Ying Wang
Mei Han
Yao-Tan Li
Zhen Wang
Jian-Ping Liu
Efficacy and safety of Tripterygium wilfordii polyglycosides for diabetic kidney disease: an overview of systematic reviews and meta-analyses
Systematic Reviews
Diabetic kidney disease
Tripterygium wilfordii polyglycoside
Systematic review
Overview
title Efficacy and safety of Tripterygium wilfordii polyglycosides for diabetic kidney disease: an overview of systematic reviews and meta-analyses
title_full Efficacy and safety of Tripterygium wilfordii polyglycosides for diabetic kidney disease: an overview of systematic reviews and meta-analyses
title_fullStr Efficacy and safety of Tripterygium wilfordii polyglycosides for diabetic kidney disease: an overview of systematic reviews and meta-analyses
title_full_unstemmed Efficacy and safety of Tripterygium wilfordii polyglycosides for diabetic kidney disease: an overview of systematic reviews and meta-analyses
title_short Efficacy and safety of Tripterygium wilfordii polyglycosides for diabetic kidney disease: an overview of systematic reviews and meta-analyses
title_sort efficacy and safety of tripterygium wilfordii polyglycosides for diabetic kidney disease an overview of systematic reviews and meta analyses
topic Diabetic kidney disease
Tripterygium wilfordii polyglycoside
Systematic review
Overview
url https://doi.org/10.1186/s13643-022-02091-3
work_keys_str_mv AT yingwang efficacyandsafetyoftripterygiumwilfordiipolyglycosidesfordiabetickidneydiseaseanoverviewofsystematicreviewsandmetaanalyses
AT meihan efficacyandsafetyoftripterygiumwilfordiipolyglycosidesfordiabetickidneydiseaseanoverviewofsystematicreviewsandmetaanalyses
AT yaotanli efficacyandsafetyoftripterygiumwilfordiipolyglycosidesfordiabetickidneydiseaseanoverviewofsystematicreviewsandmetaanalyses
AT zhenwang efficacyandsafetyoftripterygiumwilfordiipolyglycosidesfordiabetickidneydiseaseanoverviewofsystematicreviewsandmetaanalyses
AT jianpingliu efficacyandsafetyoftripterygiumwilfordiipolyglycosidesfordiabetickidneydiseaseanoverviewofsystematicreviewsandmetaanalyses