Combined use of Total Glucosides of Paeony and Hydroxychloroquine in
Primary Sjögren’s Syndrome: A Systematic Review
Abstract
Objective: To assess the effectiveness and safety of the total
glucosides of paeony (TGP) combined with Hydroxychloroquine (HCQ) on the
treatment of primary Sjögren’s syndrome (pSS) by conducting a
meta-analysis. Methods: Eight databases were searched for randomized
controlled trials reporting the use of TGP combined with HCQ for pSS,
which are before May 10,2022. Meta analyses were performed on
disappeared clinical symptoms (dry mouth, dry eyes),schirmer’s test,
saliva flow test, erythrocyte sedimentation rate (ESR), index of
immunoglobulin G(IgG), immunoglobulin M (IgM), immunoglobulin A (IgA),
and adverse events (AEs). The Revman 5.4 software was used for this
Meta-analysis.Results: Seven RCTs which included 632 participants were
identified.The pooled results showed significant differences in clinical
symptoms disappear(dry mouth, dry eyes)(P=0.0004), IgM(P <
0.00001) , IgA(P < 0.00001) , salivary flow rate(P <
0.00001) and schirmer’s test(p=0.02) in the comparison of TGP combined
with HCQ and HCQ alone. For the IgG and ESR, both pooled and subgroup
analyses showed that TGP+HCQ was superior to HCQ alone. For the safety
analysis, no significant differences in AEs(P=0.39) was revealed. The
more frequently seen adverse reactions were diarrhea, vomit and there
was no severe adverse events were reported in TGP+HCQ group. Conclusion:
Therefore, TGP+HCQ can be considered to be a potentially valid and safe
combination for the treatment of pSS in the clinic.