Efficacy and Safety of Tripterygium wilfordii Polyglycosides Versus Valsartan in Management of Diabetic Nephropathy

You-Yun Wang, Ying-Lan Cheng and Jun-Lin Zhang

Background and Objective: Valsartan is recommended to prevent the progression of diabetic nephropathy but is insufficient for the management of proteinuria. The objectives of the study were to evaluate the effectiveness and safety profile of Tripterygium wilfordii polyglycosides against valsartan in diabetic nephropathy patients. Materials and Methods: Patients with at least 1 month history of urinary protein excretion of >3 g/day and serum creatinine <1.5 mg dL^–1 have received 160 mg/day valsartan for 24 weeks (VS cohort, n = 127) or 60 mg/day Tripterygium wilfordii polyglycosides plus 160 mg/day valsartan for 24 weeks (TV cohort, n = 158) or 120 mg/day for 12 weeks followed by 60 mg/day for 12 weeks Tripterygium wilfordii polyglycosides (TP cohort, n = 165). Results: Patients of the TP cohort had a significant percentage reduction of urinary protein excretion than those of VS cohort (18.06±7.57 vs. 16.09±6.48%, p = 0.043, q = 3.419). Patients of TP (p<0.0001, q = 31.772) and TV (p<0.0001, q = 9.457) cohorts had significant percentage elevation in serum albumin levels than those of VS cohort. Patients of the VS cohort have reported dizziness, that of the TV cohort have reported dizziness and that of the TP cohort have reported liver function abnormalities and hyperkalemia. Conclusion: A total of 160 mg/day valsartan plus 60 mg/day of Tripterygium wilfordii polyglycosides for 24 weeks is recommending in the management of diabetic nephropathy in case of a large amount of proteinuria.

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