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The Chinese herb Tripterygium wilfordii Hook F for the treatment of systemic sclerosis-associated interstitial lung disease: data from a Chinese EUSTAR Center

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Abstract

Objective

To assess the efficacy and safety of the Chinese herb Tripterygium wilfordii Hook F (TwHF) for the treatment of systemic sclerosis-associated interstitial lung disease (SSc-ILD).

Methods

SSc-ILD patients who were regularly treated for more than 1 year and were currently taking a stable dose of TwHF (40–60 mg/day) or CYC (100 mg/day) were selected from the EUSTAR database of Peking Union Medical College Hospital. The efficacy of treatments was assessed by the change in pulmonary function, including the forced vital capacity (FVC) and the percentage of predicted FVC (FVC pred%).

Results

Among the 431 patients diagnosed with SSc-ILD, 76 fulfilled the inclusion and exclusion criteria. Twenty eight patients received TwHF monotherapy, while 48 received oral CYC monotherapy. Baseline data prior to treatment did not differ significantly between the two groups. After 1 year of treatment, significant improvements in the FVC and FVC pred% were seen in both groups (P < 0.05) and the magnitude of improvement was comparable (P = 0.93). However, TwHF was only found to be effective in improving FVC and FVC pred% when administered as a maintenance therapy, but not as an induction therapy. No severe adverse events were seen in either group. Leucopenia occurred more often in the CYC group compared to the TwHF group (P = 0.034).

Conclusion

TwHF may be considered as a potential alternative drug for SSc-ILD patients, especially as a maintenance therapy. A prospective randomized controlled trial is necessary to further confirm these results.

Key Points

• This is the first clinical study of Tripterygium wilfordii Hook F (TwHF) in the treatment of SSc-ILD, providing a novel therapeutic option for SSc-ILD.

• TwHF shows a comparable therapeutic efficacy to CYC when treating SSc-ILD.

• TwHF has unique therapeutic advantages considering the balance of economy and safety and may be a good potential choice for maintenance therapy.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Data access and responsibility

The principal investigators, Dong Xu and Xiaofeng Zeng, had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

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Funding

This work was supported by the National Key Research and Development Program of China (grant no. 2016YFC0901500); Center for Rare Diseases Research, Chinese Academy of Medical Sciences, Beijing, China (grant no. 2016ZX310174-4); and a grant from CAMS Innovation Fund for Medical Sciences (CIFMS; no. 2016-I2M-1-002).

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Authors and Affiliations

  1. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China

    Luwei Yang, Qian Wang, Yong Hou, Jiuliang Zhao, Mengtao Li, Dong Xu & Xiaofeng Zeng

Authors
  1. Luwei Yang
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  2. Qian Wang
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  3. Yong Hou
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  4. Jiuliang Zhao
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  5. Mengtao Li
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  6. Dong Xu
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  7. Xiaofeng Zeng
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Corresponding authors

Correspondence to Dong Xu or Xiaofeng Zeng.

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The study protocol was approved by the Medical Ethics Committee of PUMCH (Beijing, China). Informed consent was not relevant as it was a retrospective study.

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Yang, L., Wang, Q., Hou, Y. et al. The Chinese herb Tripterygium wilfordii Hook F for the treatment of systemic sclerosis-associated interstitial lung disease: data from a Chinese EUSTAR Center. Clin Rheumatol 39, 813–821 (2020). https://doi.org/10.1007/s10067-019-04784-y

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  • DOI: https://doi.org/10.1007/s10067-019-04784-y

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