Efficacy and safety of Chinese herbal medicines combined with cyclophosphamide for connective tissue disease-associated interstitial lung disease: A meta-analysis of randomized controlled trials

Study answer

What this study found

Chinese herbal medicines added to cyclophosphamide improved clinical outcomes and lung function in CTD-ILD compared with cyclophosphamide alone. The combination was associated with better VC (WMD 9.49, 95% CI 5.54 to 13.45), FVC (SMD 0.83, 95% CI 0.36 to 1.29), FEV1 (SMD 0.54, 95% CI 0.23 to 0.86), TLC (SMD 0.90, 95% CI 0.68 to 1.13), DLCO (SMD 1.05, 95% CI 0.38 to 1.73), MVV (SMD 0.83, 95% CI 0.50 to 1.17), HRCT lung integral (SMD -2.02, 95% CI -3.14 to -0.91), and ESR (WMD -13.33, 95% CI -18.58 to -8.09). Clinical efficacy rate was also higher with the combination (RR 1.21, 95% CI 1.09 to…

Study & population

This was a meta-analysis of 7 randomized controlled trials conducted in China in patients with connective tissue disease-associated interstitial lung disease, including systemic sclerosis, dermatomyositis/polymyositis, primary Sjogren's syndrome, rheumatoid arthritis, and systemic lupus erythematosus.

Intervention

Chinese herbal medicines were given as add-on therapy to cyclophosphamide in patients with CTD-ILD, with glucocorticoids used as background treatment in both groups.

Key limitation

The evidence base was limited by low trial quality, heterogeneity, and small sample sizes within individual studies.

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Original abstract