ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 2420

Quality Assessment of Controlled Trials Evaluating Chinese Herbal Medicine in Patients with Rheumatoid Arthritis:  a Systematic Review

Xin Pan1,2, Maria A. Lopez-Olivo2, Pratibha Nayak3 and Maria E. Suarez-Almazor4, 1Department of Rheumatology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China, 2Department of General Internal Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, 3General Internal Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, 4The Department of General Internal Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: clinical trials, herbal remedies, meta-analysis, quality reporting and rheumatoid arthritis (RA)

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Title: Rheumatoid Arthritis - Clinical Aspects (ACR): Impact of Various Interventions and Therapeutic Approaches

Session Type: Abstract Submissions (ACR)

Background/Purpose: Chinese herbal medicine (CHM) is a mainstay in the treatment of rheumatoid arthritis (RA) in China. We conducted a systematic review to appraise the methodological quality of controlled clinical trials evaluating the efficacy and safety of CHM in patients with RA.

Methods:  We searched electronic databases (Medline, EMBASE, The Cochrane Library, and Web of Science) from inception until May 2014 for controlled trials (randomized or not) evaluating the use of CHM including herbals and decoctions (i.e., “tang”), in patients with RA.  The search was not limited by language, year of publication or type of publication. Study selection was performed by 2 independent reviewers. Data extraction and the methodological quality of the trials was assessed using the Cochrane risk of bias tool for randomized trials and Newcastle Ottawa Scale for controlled non-randomized studies.  Descriptive statistics were used to report on risk of selection, performance, detection, attrition, reporting biases and others (i.e., conflict of interests) for randomized trials and selection, comparability and outcome biases for cohort studies.

Results:  Out of 2,125 unique citations only 54 studies were included (51 randomized trials and 3 non-randomized studies) including 7,792 patients.  Only one study was conducted in the US, the remaining in China. There were 3,446 patients receiving CHM. In the control groups 2,283 patients received a disease modifying anti-rheumatic drug (DMARD) (i.e., methotrexate, leflunomide, sulfasalazine, and etanercept), 182 non-steroidal anti-inflammatory drugs (NSAIDs), and 164 inert placebo. Additionally, 1,717 received combined CHM + either DMARD or NSAIDs. In 23 studies patients were described as having active disease, 13 included patients with more than 1 year disease duration, 1 included patients with RA and anemia, and 17 included patients with one or two traditional Chinese medicine (TCM) ‘pathological factors’ (i.e., feng, shi, and/or han). Discontinuations were not reported in 31 studies, but ranged from 0 to 55% in the remaining studies. For the randomized studies, when evaluating selection bias 54% of the studies were judged to have an adequate random sequence generation, but 77% had inadequate allocation concealment.  79% had a high risk of performance bias (not blinding participants and/or personnel) and detection bias was unclear in 56% of the studies; 62% of the studies reported how missing data was handled, therefore attrition bias was judged to be low. In 87% no disclosure of interest or source of founding was reported. For non-randomized studies, all the studies were representative of RA patients, had an adequate ascertainment of intervention with comparable groups, but only one demonstrated that the outcome of interest was not present at start of study or provided the rate of lost to follow-up.

Conclusion:  Studies evaluating CHM often fail to meet expected methodological criteria, and high quality evidence is lacking. Future studies of CHM should be methodologically robust and adhere to reporting guidelines such as the CONSORT statement for TCM.


Disclosure:

X. Pan,
None;

M. A. Lopez-Olivo,
None;

P. Nayak,
None;

M. E. Suarez-Almazor,
None.

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/quality-assessment-of-controlled-trials-evaluating-chinese-herbal-medicine-in-patients-with-rheumatoid-arthritis-a-systematic-review/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology