Researchers from the Beijing University of Chinese Medicine evaluated the incidence rate of nephrotoxicity (toxicity in the kidneys) resulting from the use of Tripterygium wilfordii Hook. F (TwHF) preparations approved by the China Food and Drug Administration, as well as the potential risk factors involved. Their results were published in The Journal of Alternative and Complementary Medicine.

• T. wilfordii, also known as thunder god vine, is a traditional Chinese herbal medicine used to treat rheumatoid arthritis (RA).
• Previous studies have shown that TwHF preparations are more effective against RA than Western medicine or Chinese patent medicines.
• T. wilfordii also contains anti-inflammatory and immunusuppressive compounds that can treat other autoimmune and inflammatory disease, such as ankylosing spondylitis and systemic lupus erythematosus.
• To determine its safety for clinical use, the researchers searched several databases (e.g., CENTRAL, PubMed, SinoMed, Chinese National Knowledge Infrastructure, VIP, China Important Conference Papers Database and online clinical trial registry websites) for articles published until November 23, 2017 which included reports on the nephrotoxicity of TwHF preparations. They set no limitations for study design.
• They found 36 articles involving 2,017 participants. The results of these studies showed that the nephrotoxicity of TwHF preparations is 5.81 percent.
• Subgroup analysis revealed that possible risk factors such as disease type, combined medication, duration and study design had no influence on the incidence of nephrotoxicity associated with TwHF use.

The researchers acknowledged that their meta-analysis was limited in terms of number of articles, sample size and poor methodology quality. With this in mind, they concluded that the incidence rate of nephrotoxicity of TwHF preparations might be overestimated in their study. They emphasized the need for more studies so potential influence factors can be identified and explored.

Journal Reference:

Feng X, Fang SN, Liang N, Liu JP, Chen W. NEPHROTOXICITY OF TRIPTERYGIUM WILFORDII HOOK. F PREPARATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS. The Journal of Alternative and Complementary Medicine. 18 January 2019;25(1):16–31. DOI: 10.1089/acm.2018.0270