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Meta-Analysis
. 2023 Mar 22:14:1024120.
doi: 10.3389/fimmu.2023.1024120. eCollection 2023.

Efficacy and safety of dietary polyphenols in rheumatoid arthritis: A systematic review and meta-analysis of 47 randomized controlled trials

Zhiyong Long  1 , Wang Xiang  2 , Qi He  3 , Wei Xiao  2 , Huagen Wei  4 , Hao Li  5 , Hua Guo  5 , Yuling Chen  5 , Mengxia Yuan  6 , Xiao Yuan  7 , Liuting Zeng  8 , Kailin Yang  7 , Yuxuan Deng  9 , Zhen Huang  1
Affiliations
Meta-Analysis

Efficacy and safety of dietary polyphenols in rheumatoid arthritis: A systematic review and meta-analysis of 47 randomized controlled trials

Zhiyong Long et al. Front Immunol. .

Abstract

Objective: To evaluate safety and efficacy of dietary polyphenols in the treatment of rheumatoid arthritis (RA).

Methods: CNKI, Pubmed, Cochrane library, Embase were searched to collect randomized controlled trials (RCTs) of dietary polyphenols in the treatment of RA. The databases were searched from the time of their establishment to November 8nd, 2022. After 2 reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies, Meta-analysis was performed using RevMan5.4 software.

Results: A total of 49 records (47 RCTs) were finally included, involving 3852 participants and 15 types of dietary polyphenols (Cinnamon extract, Cranberry extract, Crocus sativus L. extract, Curcumin, Garlic extract, Ginger extract, Hesperidin, Olive oil, Pomegranate extract, Puerarin, Quercetin, Resveratrol, Sesamin, Tea polyphenols, Total glucosides of paeony). Pomegranate extract, Resveratrol, Garlic extract, Puerarin, Hesperidin, Ginger extract, Cinnamon extract, Sesamin only involve in 1 RCT. Cranberry extract, Crocus sativus L. extract, Olive oil, Quercetin, Tea polyphenols involve in 2 RCTs. Total glucosides of paeony and Curcumin involve in more than 3 RCTs. These RCTs showed that these dietary polyphenols could improve disease activity score for 28 joints (DAS28), inflammation levels or oxidative stress levels in RA. The addition of dietary polyphenols did not increase adverse events.

Conclusion: Dietary polyphenols may improve DAS28, reduce C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and improve oxidative stress, etc. However, more RCTs are needed to verify or modify the efficacy and safety of dietary polyphenols.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022315645.

Keywords: dietary polyphenols; meta-analysis; randomized controlled trial; rheumatoid arthritis; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of clinical research.
Figure 2
Figure 2
(A) risk of bias graph; (B) risk of bias summary.
Figure 3
Figure 3
Efficacy indicators of Total glucosides of paeony (A) DAS28; (B) ACR20; (C) ACR50; (D) ACR70.
Figure 4
Figure 4
Inflammatory parameters of Total glucosides of paeony (A) CRP; (B) ESR; (C) RF; (D) IL-6.
Figure 5
Figure 5
Adverse events in Total glucosides of paeony.
Figure 6
Figure 6
DAS28 in Tea polyphenols.
Figure 7
Figure 7
CRP in Tea polyphenols.
Figure 8
Figure 8
DAS28 in Crocus sativus L.
Figure 9
Figure 9
ESR in Crocus sativus L.
Figure 10
Figure 10
DAS28 in curcumin.
Figure 11
Figure 11
Inflammatory parameters of curcumin (A) CRP; (B) ESR; (C) RF.
Figure 12
Figure 12
Adverse events.
Figure 13
Figure 13
Sensitivity Analysis results (A) adverse events of total glucosides of paeony; (B) CRP of total glucosides of paeony; (C) DAS28 of total glucosides of paeony; (D) ESR of total glucosides of paeony; (E) RF of total glucosides of paeony; (F) CRP of curcumin; (G) DAS28 of curcumin; (H) ESR of curcumin; (I) RF of curcumin.
Figure 14
Figure 14
Publication bias results (A) adverse events of total glucosides of paeony; (B) CRP of total glucosides of paeony; (C) DAS28 of total glucosides of paeony; (D) ESR of total glucosides of paeony; (E) RF of total glucosides of paeony; (F) CRP of curcumin; (G) DAS28 of curcumin; (H) ESR of curcumin; (I) RF of curcumin.
Figure 15
Figure 15
Meta-regression Results of the duration of intervention (A) adverse events of total glucosides of paeony; (B) CRP of total glucosides of paeony; (C) DAS28 of total glucosides of paeony; (D) ESR of total glucosides of paeony; (E) RF of total glucosides of paeony; (F) CRP of curcumin; (G) DAS28 of curcumin; (H) ESR of curcumin.
Figure 16
Figure 16
Meta-regression Results of dose (A) adverse events of total glucosides of paeony; (B) CRP of total glucosides of paeony; (C) DAS28 of total glucosides of paeony; (D) ESR of total glucosides of paeony; (E) RF of total glucosides of paeony; (F) CRP of curcumin; (G) DAS28 of curcumin; (H) ESR of curcumin; (I) RF of curcumin.
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References

    1. Scherer HU, Häupl T, Burmester GR. The etiology of rheumatoid arthritis. J Autoimmun (2020) 110:102400. doi: 10.1016/j.jaut.2019.102400 - DOI - PubMed
    1. Radu AF, Bungau SG. Management of rheumatoid arthritis: An overview. Cells (2021) 10(11):2857. doi: 10.3390/cells10112857 - DOI - PMC - PubMed
    1. Sparks JA. Rheumatoid arthritis. Ann Intern Med (2019) 170(1):ITC1–ITC16. doi: 10.7326/AITC201901010 - DOI - PubMed
    1. Cush JJ. Rheumatoid arthritis: Early diagnosis and treatment. Med Clin North Am (2021) 105(2):355–65. doi: 10.1016/j.mcna.2020.10.006 - DOI - PubMed
    1. Dai Y, Wang W, Yu Y, Hu S. Rheumatoid arthritis-associated interstitial lung disease: an overview of epidemiology, pathogenesis and management. Clin Rheumatol (2021) 40(4):1211–20. doi: 10.1007/s10067-020-05320-z - DOI - PubMed