AB0480 IS TRADITIONAL CHINESE MEDICINE A GOOD OPTION IN METHOTREXATE-BASED COMBINATION THERAPIES IN RHEUMATOID ARTHRITIS: A SYSTEMATIC REVIEW AND BAYESIAN NETWORK META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

Background Former findings suggested that MTX-based combination therapies show improved efficacy and safety compared to monotherapy [1] . Several studies [2] have been conducted analysis on therapies, but there is a lack of systematic involving MTX+TCM (Traditional Chinese medicine) therapies. Objectives To assess the effectiveness adverse events Methotrexate-based (MTX-based) therapies(especially MTX + TCM therapies) in rheumatoid arthritis (RA) treatment. Methods A comprehensive search PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Database for Technical Periodicals Wanfang data was done without language restriction. review network meta-analysis included randomized controlled trials methotrexate monotherapy. The ability different regimens reduce factors inflammatory indicators probability reactions were compared. This study has registered with PROSPERO under number CRD42022265799. Results total 37 studies, including 3119 patients, eligible inclusion. Meta-analysis results showed combined other DMARDs or Traditional Medicine (TCM) could serum Rheumatoid Factor (RF) C-reactive protein (CRP) levels some extent, more effective had lower rate effects. RF reducing ranked ascending order: MTX+LEF+TCM > MTX+SSZ+HCQ MTX+LEF >MTX+TCM >MTX+HCQ >MTX.While CRP MTX+LEF+TCM>MTX+SSZ+HCQ>MTX+LEF>MTX+TCM>MTX+HCQ. Conclusion Overall, are an treatment, safer. For treating patients inadequate response MTX, remain alternative, cost-effective option. support validate potential RA, large-scale, high-quality RCTs should be future provide accurate complete data. References [1]Bredemeier M, Ranza R, Kakehasi AM.et al.Safety Methotrexate-leflunomide Combination Arthritis: Multicentric, Registry-based, Cohort Study (BiobadaBrasil). J Rheumatol. 2022 Jan;49(1):122. [2]Hazlewood GS, Barnabe C, Tomlinson G.et al.Methotrexate therapy traditional biologic disease modifying antirheumatic drugs arthritis: abridged meta-analysis. BMJ. 2016 Apr 21;353:i1777. Disclosure Interests None declared. Figure 1. Forest plot (A, MTX+SSZ+HCQ; B,MTX+TCM; C,MTX+HCQ; D,MTX+LEF+TCM; E,MTX+LEF; F,MTX) 2. 3. gastrointestinal Declared.