Outcomes reporting in clinical trials of Chinese herbal medicine on ulcerative colitis: A systematic review

Ulcerative colitis (UC) is a prevalent type of inflammatory bowel disease (IBD) characterized by inflammation and ulceration in the rectum and colon.1 The optimal therapeutic effect of current treatment strategies for UC may be unattainable; even surgery may be followed by ongoing morbidity. Pharmacological therapies, mainly including aminosalicylates, steroids, immunosuppressants, etc., are used to control the acute onset of UC, heal the mucosa, and prevent complications.2 In clinical practice, some patients, however, may experience a gradual loss of response to the therapy while others may show intolerance to the adverse effects of drugs.3 Consequently, an increasing number of UC patients (21%–60%) prefer to seek additional help from Chinese herbal medicine (CHM). While numerous clinical studies have demonstrated the efficacy of CHM therapies in relieving symptoms, enhancing the therapeutic effects of chemical drugs, and reducing side effects and recurrence rates in UC patients, recommending CHM interventions for UC treatment remains cautious due to significant issues related to the choice and reporting of outcome measures.4-7 The lack of agreed-upon and standardized evaluation criteria, such as tongue and pulses in Chinese medicine (CM), contributes to considerable variation in outcome measurement and reporting among studies, making comparisons challenging.8 Therefore, we aim to summarize existing endpoint definitions and measurement tools, and inspect the efficacy and safety outcomes reported in randomized controlled trials (RCTs) of CHM in adults with UC. Given that some UC patients in China receive integrative Chinese and Western Medicine (ICWM) therapy over CHM or Western Medicine (WM) alone, the development of a core outcome set (COS) for CHM studies of UC is crucial. Such a COS would help reduce outcome heterogeneity, enhance study quality, and contribute to generating robust evidence for innovative UC therapies, ultimately fostering international recognition in the field.

Contributors

Xuan Zhang, Lin Zhang, Juan Wang, Lihan Hu, Xuanqi Zhang, Nana Wang, Hanzhi Tan, Chung Wah Cheng, Ji Li, Fei Han, Ping Wang, Aiping Lyu, Zhaoxiang Bian

Publication

Journal: Journal of Evidence-Based Medicine
Volume:
Issue:
Pages: -
Year: 2024
DOI: 10.1111/jebm.12649

Further Study Information

Current Stage: Completed
Date:
Funding source(s): This work is supported by Chinese Medicine Development Fund, Hong Kong, China (23B2/027A_R1); Center for Evidence Based Traditional Chinese Medicine, CCEBTM (2020YJSZX-5); National Natural Science Foundation of China (No. 81704198); and Donation funding of Vincent V.C. Woo Chinese Medicine Clinical Research Institute. The funders had no role in the design of study, in the collection, analysis, and interpretation of data, nor the writing of the manuscript.


Health Area

Disease Category: Gastroenterology

Disease Name: Inflammatory bowel disease (IBD), Ulcerative colitis

Target Population

Age Range: 0 - 100

Sex: Either

Nature of Intervention: Other

Stakeholders Involved

Study Type

- Systematic review of outcomes measured in trials

Method(s)

- Systematic review