Traditional Chinese Medicine for Rheumatoid Arthritis: A Scoping Review of 18 Systematic Review or Meta-Analyses

OBJECTIVES: This scoping review aims to summarize the evidence from SR/MAs of traditional Chinese medicine (TCM) for the treatment of rheumatoid arthritis (RA) and to evaluate the breadth and methodological quality of this evidence.

METHODS: The scoping review process is guided by the methodology framework of “Arksey and O’Malley framework”. Multiple electronic databases are searched online from inception until September 6, 2023. Two reviewers independently screen full texts and extracted basic characteristics of SRs. In addition, the AMSTAR 2 tool is also used to assess methodological quality.

RESULTS: A total of 18 SR/MAs were included. China (77.78%) had the highest number of SR/MAs. SR/MAs were published between 2003 and 2023, with the majority published between 2015 and 2023. The methodological quality of the included SR/MAs were relatively not high. 18 SR/MAs involved 55 kinds of treatment interventions and 47 control interventions. The most SR/MAs results showed that TCM treatment for RA is more effective than conventional drugs in terms of treatment efficacy, improvement of morning stiffness duration, grip strength, rheumatoid factors, pain, erythrocyte sedimentation rate, C-reactive protein, tender joint count, and swollen joint count. In addition, the most SR/MAs also indicated that the adverse effects of TCM are lower than those of the control group, and the combination of TCM and Western medicine can also alleviate the adverse effects of western medicine.

CONCLUSIONS: This study provides some reference for the clinical application of TCM in the treatment of RA. SR/MAs have suggested that the evidence level for the outcomes of TCM treatment for RA is relatively low. Additionally, there is a need to improve the methodological quality of the studies in this area. It's important for further research to focus on conducting high-quality studies to better understand the efficacy and safety of TCM in the treatment of RA.