Key result
Sodium Tanshinone IIA Sulfonate Injection combined with ARBs improved eGFR compared to ARBs monotherapy (MD 6.87; 95% CI 4.47-9.28; P<0.00001) in patients with hypertensive nephropathy.
Why the study?
Sodium Tanshinone IIA Sulfonate Injection is supposed to be a supplementary treatment in hypertensive nephropathy, but its efficacy and safety required evaluation.
Does Sodium Tanshinone IIA Sulfonate Injection combined with ARBs improve renal function and blood pressure in patients with primary hypertensive nephropathy compared to ARBs monotherapy?
Meta-Analysis (n=1,696)
Does Sodium Tanshinone IIA Sulfonate Injection combined with ARBs improve renal function and blood pressure in patients with primary hypertensive nephropathy compared to ARBs monotherapy?
Mean Difference: 6.87 (95% CI 4.47–9.28)
p-value: p=< 0.00001
Sodium Tanshinone IIA Sulfonate Injection combined with ARBs may improve renal function and provide auxiliary hypotensive effects in patients with hypertensive nephropathy, though high-quality RCTs are needed to confirm these findings.
STS adjunct to ARBs may enhance renal outcomes in hypertensive nephropathy; extends meta-analytic evidence but warrants confirmatory RCTs before practice change.
Background: Sodium Tanshinone ⅡA Sulfonate Injection (STS), the extractive of traditional Chinese medicine Danshen, is supposed to be a supplementary treatment in hypertensive nephropathy. Objectives: To evaluate the efficacy and safety of STS in treatment of hypertensive nephropathy. Methods: We systematically searched China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Wan-fang database, Chinese Biomedicine Database (CBM), PubMed, EMBASE, Web of Science, and Cochrane Library from their inception to November, 2018. All studies were screened by two reviewers according to the inclusion and exclusion criteria independently. The Cochrane Collaboration's risk tool was used to assess the methodological quality of the included studies. Reviewer Manger 5.3 was employed for statistics analysis. Results: Sixteen trials involving 1696 patients were included. The meta-analysis results indicated a combination of STS and ARBs was more effective than ARBs monotherapy in modulating hypertensive nephropathy, as represented by improved eGFR [MD = 6.87, 95% CI (4.47, 9.28), P < 0.00001] and reduced 24-hour urinary protein [MD = -0.23, 95% CI (-0.27, -0.19), P < 0.00001], SCr [MD = -21.74, 95% CI (-24.11, -19.38), P < 0.00001], cystatin-C [MD = -0.16, 95% CI (-0.24, -0.07), P = 0.0003], urinary IgG [MD = -0.85, 95% CI (-1.11, -0.59), P < 0.00001] and urinary transferrin [MD = -0.61, 95% CI (-1.04, -0.17), P = 0.007]. In addition, the combination therapy had better control in SBP [MD = -6.53, 95% CI (-8.19, -4.87), P < 0.00001] and DBP [MD = -4.14, 95% CI (-5.69, -2.59), P < 0.00001]. Only 3 trials reported adverse events, and no adverse drug reactions were observed. Conclusions: STS combined with ARBs had a stronger effect on improving renal function in patients with primary hypertensive nephropathy than ARBs monotherapy. The combination therapy also provided auxiliary hypotensive effects. Further large-scale, multicenter, and rigorously designed RCTs should be conducted to confirm our findings.
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Xu et al. (2019) conducted a meta-analysis in Hypertensive nephropathy (n=1,696). Sodium Tanshinone IIA Sulfonate Injection (STS) combined with ARBs vs. ARBs monotherapy was evaluated on eGFR (MD 6.87, 95% CI 4.47, 9.28, p=< 0.00001). Sodium Tanshinone IIA Sulfonate Injection combined with ARBs improved eGFR compared to ARBs monotherapy (MD 6.87; 95% CI 4.47-9.28; P<0.00001) in patients with hypertensive nephropathy.
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