The Effects of Modified Simiao Decoction in the Treatment of Gouty Arthritis: A Systematic Review and Meta‐Analysis

The modified Simiao decoctions (MSD) have been wildly applied in the treatment of gouty arthritis in China. However, the evidence needs to be evaluated by a systematic review and meta‐analysis. After filtering, twenty‐four randomised, controlled trials (RCTs) comparing the effects of MSD and anti‐inflammation medications and/or urate‐lowering therapies in patients with gouty arthritis were included. In comparison with anti‐inflammation medications, urate‐lowering therapies, or coadministration of anti‐inflammation medications and urate‐lowering therapies, MSD monotherapy significantly lowered serum uric acid (p < 0.00001, mean difference = −90.62, and 95% CI [−128.38, −52.86]; p < 0.00001, mean difference = −91.43, and 95% CI [−122.38, −60.49]; p = 0.02, mean difference = −40.30, and 95% CI [−74.24, −6.36], resp.). Compared with anti‐inflammation medications and/or urate‐lowering therapies, MSD monotherapy significantly decreased ESR (p < 0.00001; mean difference = −8.11; 95% CI [−12.53, −3.69]) and CRP (p = 0.03; mean difference = −3.21; 95% CI [−6.07, −0.36]). Additionally, the adverse effects (AEs) of MSD were fewer (p < 0.00001; OR = 0.08; 95% CI [0.05, 0.16]). MSD are effective in the treatment of gouty arthritis through anti‐inflammation and lowering urate. However, the efficacy of MSD should be estimated with more RCTs.