{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T00:37:26Z","timestamp":1793839046340,"version":"4.6.1"},"reference-count":43,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Ethnopharmacology"],"published-print":{"date-parts":[[2023,5]]},"DOI":"10.1016\/j.jep.2023.116211","type":"journal-article","created":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T10:57:31Z","timestamp":1674644251000},"page":"116211","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":26,"special_numbering":"C","title":["Tripterygium wilfordii Hook F combination therapy with methotrexate for rheumatoid arthritis: An updated meta-analysis"],"prefix":"10.1016","volume":"307","author":[{"given":"Yijun","family":"Luo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anran","family":"Xi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengxian","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keer","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0033-525X","authenticated-orcid":false,"given":"Zhenghao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"7","key":"10.1016\/j.jep.2023.116211_bib1","doi-asserted-by":"crossref","first-page":"10018","DOI":"10.1002\/jcp.27860","article-title":"Strategies toward rheumatoid arthritis therapy; the old and the new","volume":"234","author":"Abbasi","year":"2019","journal-title":"J. Cell. Physiol."},{"issue":"13","key":"10.1016\/j.jep.2023.116211_bib2","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1001\/jama.2018.13103","article-title":"Diagnosis and management of rheumatoid arthritis: a review","volume":"320","author":"Aletaha","year":"2018","journal-title":"JAMA"},{"issue":"4","key":"10.1016\/j.jep.2023.116211_bib3","first-page":"242","article-title":"2018 Chinese guideline for the diagnosis and treatment of rheumatoid arthritis","volume":"57","author":"Association","year":"2018","journal-title":"Chin. J. Intern. Med."},{"issue":"7","key":"10.1016\/j.jep.2023.116211_bib4","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1002\/acr.24596","article-title":"2021 American College of rheumatology guideline for the treatment of rheumatoid arthritis","volume":"73","author":"Fraenkel","year":"2021","journal-title":"Arthritis Care Res."},{"issue":"11","key":"10.1016\/j.jep.2023.116211_bib5","first-page":"1511","article-title":"Efficacy of tripterygium wilfordii glycosides combined with methotrexate in the treatment of rheumatoid arthritis","volume":"29","author":"Gao","year":"2017","journal-title":"Med. J. West Chin."},{"key":"10.1016\/j.jep.2023.116211_bib6","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1038\/s41413-018-0016-9","article-title":"Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies","volume":"6","author":"Guo","year":"2018","journal-title":"Bone Res."},{"key":"10.1016\/j.jep.2023.116211_bib8","series-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins","year":"2008"},{"key":"10.1016\/j.jep.2023.116211_bib9","article-title":"Promising therapeutic targets for treatment of rheumatoid arthritis","volume":"12","author":"Huang","year":"2021","journal-title":"Front. Immunol."},{"issue":"1","key":"10.1016\/j.jep.2023.116211_bib10","doi-asserted-by":"crossref","DOI":"10.3390\/jcm8010015","article-title":"Risk of infection with methotrexate therapy in inflammatory diseases: a systematic review and meta-analysis","volume":"8","author":"Ibrahim","year":"2018","journal-title":"J. Clin. Med."},{"issue":"3","key":"10.1016\/j.jep.2023.116211_bib11","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1136\/ard.2003.013276","article-title":"Activation of the STAT1 pathway in rheumatoid arthritis","volume":"63","author":"Kasperkovitz","year":"2004","journal-title":"Ann. Rheum. Dis."},{"issue":"16","key":"10.1016\/j.jep.2023.116211_bib12","first-page":"3542","article-title":"Meta-analysis of laboratory index of Tripterygium Glycosides Tablets in treatment of rheumatoid arthritis","volume":"44","author":"Li","year":"2019","journal-title":"China J. Chin. Mater. Med."},{"issue":"16","key":"10.1016\/j.jep.2023.116211_bib13","first-page":"4","article-title":"Effects observation of different treatment program in rheumatoid arthritis","volume":"23","author":"Lin","year":"2016","journal-title":"China Mod. Med."},{"key":"10.1016\/j.jep.2023.116211_bib14","first-page":"71","article-title":"Efficacy of Tripterygium wilfordii polyglycoside tablets combined with methotrexate in the treatment of rheumatoid arthritis","volume":"16","author":"Long","year":"2019","journal-title":"China Med. Her"},{"issue":"1","key":"10.1016\/j.jep.2023.116211_bib15","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12906-016-1504-3","article-title":"Triptolide Induces hepatotoxicity via inhibition of CYP450s in Rat liver microsomes","volume":"17","author":"Lu","year":"2017","journal-title":"BMC Compl. Alternative Med."},{"issue":"6","key":"10.1016\/j.jep.2023.116211_bib16","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1136\/annrheumdis-2013-204807","article-title":"Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis (TRIFRA): a randomised, controlled clinical trial","volume":"74","author":"Lv","year":"2015","journal-title":"Ann. Rheum. Dis."},{"issue":"12","key":"10.1016\/j.jep.2023.116211_bib17","doi-asserted-by":"crossref","first-page":"5785","DOI":"10.1093\/rheumatology\/keab254","article-title":"What is the incidence of methotrexate or leflunomide discontinuation related to cytopenia, liver enzyme elevation or kidney function decline?","volume":"60","author":"Nakafero","year":"2021","journal-title":"Rheumatology"},{"issue":"16","key":"10.1016\/j.jep.2023.116211_bib18","first-page":"3374","article-title":"Progress of effect and mechanisms of Tripterygium wilfordii on immune system","volume":"44","author":"Nong","year":"2019","journal-title":"China J. Chin. Mater. Med."},{"issue":"2","key":"10.1016\/j.jep.2023.116211_bib20","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1093\/intimm\/dxl128","article-title":"TGF-\u03b2 type I receptor kinase inhibitor down-regulates rheumatoid synoviocytes and prevents the arthritis induced by type II collagen antibody","volume":"19","author":"Sakuma","year":"2007","journal-title":"Int. Immunol."},{"key":"10.1016\/j.jep.2023.116211_bib21","article-title":"Rheumatoid arthritis","volume":"4","author":"Smolen","year":"2018","journal-title":"Nat. Rev. Dis. Prim."},{"issue":"6","key":"10.1016\/j.jep.2023.116211_bib22","doi-asserted-by":"crossref","first-page":"369","DOI":"10.7326\/M19-3369","article-title":"Adverse effects of low-dose methotrexate: a randomized trial","volume":"172","author":"Solomon","year":"2020","journal-title":"Ann. Intern. Med."},{"key":"10.1016\/j.jep.2023.116211_bib23","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"10.1016\/j.jep.2023.116211_bib24","first-page":"7","article-title":"Efficacy evaluation of tripterygium wilfordii glycosides combined with methotrexate in the treatment of rheumatoid arthritis and effect on TNF-\u03b1 and IL-6","volume":"17","author":"Tan","year":"2010","journal-title":"Chin. J. Inf. Tradit. Chin. Med."},{"key":"10.1016\/j.jep.2023.116211_bib25","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2020.583171","article-title":"Tripterygium ingredients for pathogenicity cells in rheumatoid arthritis","volume":"11","author":"Tang","year":"2020","journal-title":"Front. Pharmacol."},{"key":"10.1016\/j.jep.2023.116211_bib27","author":"Tian"},{"issue":"3","key":"10.1016\/j.jep.2023.116211_bib28","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1002\/ptr.5987","article-title":"Efficacy and safety of Tripterygium wilfordii Hook F for CKD in Mainland China: a systematic review and meta-analysis","volume":"32","author":"Wang","year":"2018","journal-title":"Phytother Res."},{"key":"10.1016\/j.jep.2023.116211_bib29","article-title":"A systematic review about the efficacy and safety of Hook.f. Preparations used for the management of rheumatoid arthritis","author":"Wang","year":"2018","journal-title":"Evid Based Complement Alternat Med"},{"key":"10.1016\/j.jep.2023.116211_bib30","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.3389\/fphar.2018.01051","article-title":"Treatment of rheumatoid arthritis using combination of methotrexate and tripterygium glycosides tablets-A quantitative plasma pharmacochemical and pseudotargeted metabolomic approach","volume":"9","author":"Wang","year":"2018","journal-title":"Front. Pharmacol."},{"issue":"16","key":"10.1016\/j.jep.2023.116211_bib31","first-page":"3533","article-title":"[Clinical symptoms effect of Tripterygium Glycosides Tablets alone or combined with methotrexate in treatment of rheumatoid arthritis: a Meta-analysis]","volume":"44","author":"Wang","year":"2019","journal-title":"China J. Chin. Mater. Med."},{"issue":"17","key":"10.1016\/j.jep.2023.116211_bib32","first-page":"2598","article-title":"Clinical observation of methotrexate combined with Tripterygium wilfordii polyglycoside in the treatment of rheumatoid arthritis","volume":"21","author":"Wang","year":"2015","journal-title":"Int. Med. Health Guid. News"},{"key":"10.1016\/j.jep.2023.116211_bib33","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.lfs.2017.01.004","article-title":"Treatment of rheumatoid arthritis with combination of methotrexate and Tripterygium wilfordii: a meta-analysis","volume":"171","author":"Wang","year":"2017","journal-title":"Life Sci."},{"issue":"11","key":"10.1016\/j.jep.2023.116211_bib34","first-page":"1678","article-title":"The observation of efficacy in Tripterygium wilfordii combined with methotrexate in the treatment of rheumatoid arthritis","volume":"20","author":"Wang","year":"2013","journal-title":"Chin. J. Prim. Med. Pharm."},{"issue":"51","key":"10.1016\/j.jep.2023.116211_bib35","first-page":"82","article-title":"Efficacy of methotrexate combined with Tripterygium wilfordii glycoside tablets in treatment of rheumatoid arthritis and analysis of side effects","volume":"5","author":"Wen","year":"2018","journal-title":"Diet Health"},{"issue":"19","key":"10.1016\/j.jep.2023.116211_bib36","first-page":"4752","article-title":"Research progress on chemical composition and pharmacological activity of Tripterygium wilfordii and predictive analysis on Q-marker","volume":"50","author":"Xiao","year":"2019","journal-title":"Chin. Tradit. Herb. Drugs"},{"issue":"16","key":"10.1016\/j.jep.2023.116211_bib37","first-page":"3406","article-title":"Overview of reproductive toxicity studies on Tripterygium wilfordii in recent 40 years","volume":"44","author":"Xu","year":"2019","journal-title":"China J. Chin. Mater. Med."},{"issue":"17","key":"10.1016\/j.jep.2023.116211_bib38","first-page":"300","article-title":"Clinical observation on treatment of rheumatoid arthritis with tripterygium wilfordii polyglycoside combined with methotrexate","volume":"19","author":"Yang","year":"2013","journal-title":"Chin. J. Exp. Tradit. Med. Formulae"},{"issue":"51","key":"10.1016\/j.jep.2023.116211_bib39","first-page":"129","article-title":"Short-term efficacy of rheumatoid arthritis treatment with methotrexate and the effect on peripheral blood inflammatory factors in patients","volume":"19","author":"Zhang","year":"2019","journal-title":"World Latest Med. Info."},{"key":"10.1016\/j.jep.2023.116211_bib40","first-page":"602","article-title":"Clinical observation of tripterygium wilfordii glycosides combined with methotrexate in the treatment of rheumatoid arthritis","author":"Zhang","year":"2012","journal-title":"Chin. J. Med. Guid. (z2)"},{"issue":"3","key":"10.1016\/j.jep.2023.116211_bib41","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1002\/med.21762","article-title":"Tripterygium wilfordii: an inspiring resource for rheumatoid arthritis treatment","volume":"41","author":"Zhang","year":"2021","journal-title":"Med. Res. Rev."},{"issue":"10","key":"10.1016\/j.jep.2023.116211_bib42","doi-asserted-by":"crossref","first-page":"e4299","DOI":"10.1002\/bmc.4299","article-title":"Metabolic alterations in triptolide-induced acute hepatotoxicity","volume":"32","author":"Zhao","year":"2018","journal-title":"Biomed. Chromatogr."},{"key":"10.1016\/j.jep.2023.116211_bib43","first-page":"191","article-title":"Efficacy of tripterygium wilfordii glycosides and methotrexate in the treatment of rheumatoid arthritis","volume":"15","author":"Zhou","year":"2017","journal-title":"Guid. Chin. Med."},{"key":"10.1016\/j.jep.2023.116211_bib44","doi-asserted-by":"crossref","first-page":"356","DOI":"10.3389\/fphar.2018.00356","article-title":"The effectiveness and safety of extracts in rheumatoid arthritis: a systematic review and meta-analysis","volume":"9","author":"Zhou","year":"2018","journal-title":"Front. Pharmacol."},{"issue":"1","key":"10.1016\/j.jep.2023.116211_bib45","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s13075-018-1563-6","article-title":"Comparison of the impact of Tripterygium wilfordii Hook F and Methotrexate treatment on radiological progression in active rheumatoid arthritis: 2-year follow up of a randomized, non-blinded, controlled study","volume":"20","author":"Zhou","year":"2018","journal-title":"Arthritis Res. Ther."},{"key":"10.1016\/j.jep.2023.116211_bib46","first-page":"339","article-title":"Clinical efficacy and follow-up analysis of methotrexate combined with Tripterygium wilfordii polyglycoside tablets in the treatment of senile rheumatoid arthritis World","volume":"15","author":"Zhu","year":"2020","journal-title":"J. Integr. Tradit. West Med."}],"container-title":["Journal of Ethnopharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S037887412300079X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S037887412300079X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T05:53:58Z","timestamp":1736402038000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S037887412300079X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":43,"alternative-id":["S037887412300079X"],"URL":"https:\/\/doi.org\/10.1016\/j.jep.2023.116211","relation":{},"ISSN":["0378-8741"],"issn-type":[{"value":"0378-8741","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Tripterygium wilfordii Hook F combination therapy with methotrexate for rheumatoid arthritis: An updated meta-analysis","name":"articletitle","label":"Article Title"},{"value":"Journal of Ethnopharmacology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jep.2023.116211","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"116211"}}