Safety Profiles of Tripterygium Wilfordii Hook F: A Systematic Review and Meta-Analysis

The systematic review and meta-analysis of Tripterygium wilfordii Hook F (TwHF) assessed its safety profile, involving 48,536 patients across 594 primary publications. While TwHF showed therapeutic benefits for conditions like rheumatoid arthritis and nephrotic syndrome, 26.7% of patients experienced adverse events (AEs), such as gastrointestinal issues, reproductive outcomes, liver and renal damage, and hair loss. Monotherapy studies reported a higher AE rate (31.6%) compared to combination therapy (25.1%). Reproductive AEs were noted in 11.7% of users, cardiovascular events in 4.9%, and liver enzyme elevation in 8.6%. Hair loss was less common in the TwHF group compared to controls. The study highlighted the increased risk of AEs with prolonged use and in children, suggesting caution in long-term use. The findings underscored the need for clinicians to balance benefits against risks and called for further research to improve patient tolerance. Limitations included variability in study types and incomplete AE reporting.