Efficacy of methimazole combined with traditional Chinese medicine in the treatment of Graves’ disease: a systematic review and network meta-analysis - Summary - MDSpire
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Efficacy of methimazole combined with traditional Chinese medicine in the treatment of Graves’ disease: a systematic review and network meta-analysis
To assess the therapeutic effects of combining Traditional Chinese Medicine (TCM) with Methimazole (MMI) in managing Graves’ Disease (GD) compared to MMI alone.
Approach:
Literature Search: A systematic literature search was performed across multiple databases for RCTs comparing TCM plus MMI versus MMI alone.
Risk of Bias Evaluation: Study risk of bias was evaluated using the Cochrane tool, and transitivity and consistency were assessed.
Network Meta-Analysis: A network meta-analysis was conducted using a random-effects model to compare treatment efficacy.
Key Findings:
A network meta-analysis of 15 RCTs involving 1,317 GD patients showed potential advantages of TCM combined with MMI over MMI alone in improving thyroid function indices and reducing autoantibodies, particularly TRAb and TPOAb. Modified Huagan Decoction (MHD) + MMI ranked first for reducing FT3, Modified Xiaoyao Powder (MXYP) + MMI for FT4, and Xiaoyao Powder (XYP) + MMI for TSH. Huotan Jiangni Formula (HJF) + MMI ranked highest for lowering TPOAb.
Interpretation:
Limitations:
Adverse event reporting was incomplete and heterogeneous across the included RCTs, which limits the interpretation of safety. The study focused on short-term efficacy, not long-term outcomes.
In a randomized crossover trial of insulin-treated patients receiving hemodialysis, real-time continuous glucose monitoring did not improve the primary hypoglycemia outcome but increased time in range and reduced time above range vs capillary testing.
