Assessment of the Therapeutic Effect of Total Glucosides of Peony for Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis

Table 3

Subgroup and sensitivity analysis.

Treatment	Outcomes	Subgroup	Number of studies and participants	Effect size (SMD, MD, OR, or RR)	Effect size, value	Heterogeneity, (%)	Heterogeneity, value
Cointervention versus control	Overall response rate		7,423
		Short term	2,141	OR = 1.55, 95% CIs, 0.68 to 3.51	0.295	0	0.963
		Intermediate term	7,423	OR = 2.47, 95 CIs, 1.22 to 5.0	0.012	0	0.862
		Long term	2,77	OR = 2.11, 95% CIs, 0.56 to 7.93	0.27	0	0.872
		Intermediate term	6,339^#	OR = 2.04, 95% CI 0.93 to 4.47	0.074	0	0.925
	ESR		7,379
		Short term	1,36	MD = −4.21 mm/h, 95% CI, −9.31 to 0.89 mm/h	0.106	—	—
		Intermediate term	7,379	MD = −3.36 mm/h, 95% CI, −5.18 to −1.54 mm/h	<0.001	58.1	0.026
		Long term	2,77	MD = −3.72 mm/h, 95% CI, −6.66 to −0.78 mm/h	0.013	91.7	0.001
		Intermediate term	6,328^#	MD = −2.93 mm/h, 95% CI, −4.92 to −1.44 mm/h	<0.001	42.3	0.123
	CRP		7,379
		Short term	1,36	SMD = −0.53, 95% CI, −1.2 to 0.13	0.117	—	—
		Intermediate term	7,379	SMD = −1.02, 95% CI, −1.67 to −0.36	0.002	88.4	<0.001
		Long term	2,77	SMD = −0.61, 95% CI, −1.19 to −0.03	0.038	35.9	0.211
		Intermediate term	5,250^#	SMD = −0.49, 95% CI, −0.82 to −0.15	0.005	41.3	0.146
		Intermediate term	6,295^#	SMD = −0.95, 95% CI, −1.70 to −0.20	0.013	88.7	<0.001
	DMS		4,232
		Short term	1,36	MD = −6.28 min, 95% CI, −16.77 to 4.21 min	0.241	—	—
		Intermediate term	4,232	MD = −18.46 min, 95% CI, −33.28 to −3.63 min	0.015	82.7	0.001
		Intermediate term	3,148^#	MD = −10.91 min, 95% CI, −17.69 to −4.12 min	0.002	0	0.502
	TJC		2,87
		Short term	1,36	MD = −2.19, 95% CI: −4.53 to 0.15	0.066	—	—
		Intermediate term	2,87	MD = −2.99, 95% CI: −5.82 to −0.16	0.038	79.9	0.026
	SJC		2,87
		Short term	1,36	MD = −2.41, 95% CI: −4.97 to 0.152	0.065	—	—
		Intermediate term	2,87	MD = −3.05, 95% CI: −6.97 to 0.87	0.127	92.8	<0.001
	IgG	Intermediate term	2,87	MD = −0.90 g/L, 95% CI: −3.39 to 1.59 g/L	0.478	80.7	0.023
	IgA	Intermediate term	2,87	MD = −0.48 g/L, 95% CI: −1.05 to 0.10 g/L	0.103	85.2	0.009
	GS	Intermediate term	1,84	MD = 1.83 kg, 95% CI: 0.68 to 2.98 Kg	0.002	—	—
	Prednisone dosage	Intermediate term	1,70	MD = −2.40 mg/d, 95% CI: −3.75 to −1.05 mg/d	0.001	—	—
	Prednisone treatment duration	Intermediate term	1,70	MD = −56 d, 95% CI: −75.12 to −36.88 d		—	—
	ACR70	Intermediate term	1,61	OR = 3.61; 95% CI: 1.09 to 11.94	0.035	—	—
	JADAS	Intermediate term	1,61	MD = −1.75; 95% CI: −2.24 to −1.26		—	—
TGP alone versus MTX alone	Overall response rate		2,99
		Short term	1,31	OR = 0.60, 95% CI: 0.12 to 3.03	0.537	—	—
		Intermediate term	2,99	OR = 1.26, 95% CI: 0.29 to 5.47	0.761	0	0.963
	DMS	Intermediate term	1,68	MD = −3.36 min, 95% CI: −9.76 to 3.16 min	= 0.316	—	—
	Pain score	Intermediate term	1,68	MD = −0.30; 95% CI: −0.53 to −0.07	= 0.010	—	—
	Doses of prednisone	Intermediate term	1,68	MD = −2.40 mg/d, 95% CI: −3.96 to −0.84 mg/d	= 0.003	—	—
	Course of prednisone	Intermediate term	1,68	MD = −56 d, 95% CI: −77.71 to −34.29 d	< 0.001	—	—
	ESR	Intermediate term	1,68	MD = −4.40 mm/h; 95% CI: −10.67 to 1.87 mm/h	= 0.169	—	—
	CRP	Intermediate term	1,68	MD = −1.6 mg/L; 95% CI: −8.53 to 5.34 mg/L	= 0.651	—	—
	AEs	Overall	5,291	OR = 0.38, 95% CI: 0.17 to 0.82	0.014	40.3	0.153
		Cointervention versus control	3,192	OR = 0.63, 95% CI: 0.30, 1.33	0.226	0	0.870
		TGP alone versus MTX alone	2,99	OR = 0.14, 95% CI: 0.03, 0.69	0.016	54.9	0.137

Sensitivity analysis after some studies were dropped out. DMS, duration of morning stiffness; TGP, total glucosides of peony; MTX, Methotrexate; TJC, tender joint count; SJC, swollen joint count; GS, grip strength; AE, adverse effect; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; JADAS, Juvenile Arthritis Disease Activity Score.