To systematically evaluate the curative clinical efficacy and safety of sinomenine (SIN) in
treatment of rheumatoid arthritis (RA) in comparison to methotrexate (MTX).
We searched the China National Knowledge Infrastructure Database, Chinese Biomedical
Literature Database, China Science and Technology Journal Database, Wanfang Database, Pubmed and
Cochrane Library electronically up to August 31, 2015, without language limitation. Only randomized
controlled trials (RCTs) were included. Software Review Manager 5.3 was used for Meta-analysis.
A total of 16 eligible studies within 1500 RA patients were included. The meta-analysis indicated
that on basis of MTX, SIN was more effective in total effective rate (P < 0.000 01). Besides, SIN
alone versus MTX also showed advantages in RA therapy (P = 0.04) Taken together, adverse events
occurred less frequently in combination of SIN and MTX than MTX alone (P < 0.0001), especially in digestive
system (P < 0.000 01),while occurred more in dermato mucosal system with SIN treatment versus
MTX (P = 0.02), and were similar for both remedies in nervous system (P = 0.12) and hematological
system (P = 0.25).
Compared to MTX, SIN had better clinical efficacy and relatively fewer adverse events
in treatment of RA, especially when it was used together with MTX. Due to the poor methodological
quality, well-designed, multiple-center RCTs are still required to further confirm the findings.