Traditional Chinese Medicine Added to MG Therapies Seen to Carry Short-term Benefits, Study Reports

Combining a traditional Chinese medicine known as Qi supplement formula with conventional therapy shows short-term benefits in myasthenia gravis (MG) patients, researchers in China report.

But more studies of better quality are needed to support these observations, they stressed.

Their study, “Efficacy and Safety of the TCM Qi-Supplementing Therapy in Patients with Myasthenia Gravis: A Systematic Review and Meta-Analysis,” appeared in the journal Evidence-Based Complementary and Alternative Medicine.

MG is a chronic autoimmune disorder with increasing incidence. Current treatment strategies include acetylcholinesterase inhibitors (which block the breakdown of the neurotransmitter acetylcholine), immunosuppressive agents, and a thymectomy (surgery to remove the thymus).

Although conventional treatment is able to control MG symptoms in most patients, a small percentage do not respond adequately and require immunosuppressive steroids at high doses, which can carry severe side effects.

Traditional Chinese medicine (TCM) considers that MG is caused by deficiency in Qi, or bodily energy. Most studies of TCM combined with Western medicines, however, have not focused specifically on Qi supplementation in treating MG, and those that did had inherent limitations, like small patient groups or poor analysis of potential side effects. Further, no meta-analysis — thorough statistical analysis — focusing specifically on Qi supplementation plus conventional Western treatments has been done.

The research team searched seven electronic databases through June 2016. Their analyses included only randomized clinical studies comparing the combined approach’s effectiveness in treatment and non-treatment (control) patient groups. Outcome measures were total effective rate, relapse rate, and adverse events.

A total of 23 clinical trials with 1,691 MG patients were analyzed, but investigators found the included studies to be of low-to-moderate quality. Still, their analysis demonstrated that Qi-supplementing (adjunctive) therapy plus Western therapies significantly improved the total response rate by 19%, and reduced the risk of relapse by 77% during six to 24 months of follow-up.

Further sub-group analysis, however, found that Qi therapy only improved the total effective rate within the first six months of treatment; little change was seen after six months of use. This finding, the researchers said, may be attributed to the low number of patients in the analysis.

Qi therapy also was seen to reduce the rate of adverse events in patients compared to those using only Western treatments, with the most prevalent side effects being gastrointestinal reactions and glucocorticoid-induced obesity.

Overall, the study “suggests that Qi-supplementing Formula therapy may have beneficial effects in the management of MG patients,” the researchers wrote. “With subgroup analyses by treatment duration and relapse of disease as outcome measures, our meta-analysis provided stronger evidence for the use of Qi-supplementing Formula in the management of MG.”

However, higher-quality clinical trials with larger cohorts and longer follow-up periods are required for more a definitive view of this treatment approach, the team cautioned.