Treatment of Rheumatoid Arthritis With Traditional Chinese Medicine: An Overview of Systematic Review

OBJECTIVES: Re-evaluation of Systematic Evaluation/Meta-Analysis (SR/MA) of Traditional Chinese Medicine for Rheumatoid Arthritis.

METHODS: Computer searches of the National Knowledge Infrastructure database (CNKI), China Biomedical Literature Database (CBM), Wanfang database, PubMed, Embase searches were conducted up to 28 December 2023.After independently screening the literature and extracting the information by two researchers, the methodological quality, reporting quality and evidence quality of the included studies were evaluated using AMSTAR-II, PRISMA 2020, and GRADE tools, respectively, and the results of the evaluation were presented in a visual way using Origin 2021.

RESULTS: A total of 49 SA/MAs were included, involving 21 TCMs and 29 outcome indicators.The results of AMSTAR-II evaluation showed that 1 SA/MA was of high quality, 8 were of low quality, and the remaining 40 were of very low quality. The PRISMA 2020 evaluation showed that 29 SA/MA reports were relatively complete, 19 had some deficiencies, and 1 had relatively severe deficiencies, with <50% completeness of reporting of programme and registry entries.The GRADE evaluation showed that all the indicators were of moderate, low, or very low quality, and that low quality of methodology, inconsistency of results, and the presence of publication bias were the main factors for downgrading the quality of evidence.

CONCLUSIONS: The efficacy of TCM combined with conventional western medicine in the treatment of rheumatoid arthritis is superior to conventional western medicine treatment, but the methodological quality, reporting quality, and evidence quality of the included SA/MA have some deficiencies, and future researchers should produce more high-quality evidence based on strict adherence to the SR/MA production tool, so as to provide evidence-based support for the clinical treatment of this disease.