Prunella Oral Liquid in combination with Western medical treatment for Graves' disease: A systematic review and meta-analysis.

In 30 seconds

This systematic review and meta-analysis assessed Prunella Oral Liquid added to Western medical treatment for Graves’ disease. It included nine randomised controlled trials involving 966 patients, comparing the herbal medicine plus treatment with the same treatment alone. In trials adding it to antithyroid drugs, the combination was associated with fewer adverse events (RR = 0.35, 95%CI [0.13,0.94]) and improvements in thyroid hormone, antibody, and thyroid-size measures. The authors concluded that it may offer additional benefit, but evidence certainty was low to very low, warranting cautious interpretation.

Key findings

• Across antithyroid-drug trials, adding Prunella Oral Liquid was associated with fewer adverse events (RR = 0.35, 95%CI [0.13,0.94]).
• With antithyroid drugs, the combination further reduced FT 3 (SMD = -0.94, 95%CI [-1.63,-0.26]) and FT 4 (SMD = -0.87, 95%CI [-1.55, -0.19]).
• Compared with antithyroid drugs alone, adding Prunella Oral Liquid lowered TRAb (SMD = -1.26, 95%CI [-1.69,-0.83]) and increased TSH (SMD = 0.79, 95%CI [0.31,1.27]).
• GRADE certainty ranged from low to very low; unclear allocation concealment and lack of blinding were key risk-of-bias concerns.

Why it matters

The review suggests that adding Prunella Oral Liquid may improve biochemical and thyroid-size outcomes, and may reduce adverse events, alongside established treatments for Graves’ disease. However, these pooled findings come from evidence with low or very low certainty. Clinicians should therefore distinguish promising signals from established benefit, particularly when interpreting surrogate measures and safety outcomes.

What to keep in mind

Evidence certainty was low to very low, with unclear allocation concealment and performance bias related to lack of blinding. The authors call for rigorously designed multicentre trials with standardised protocols.