The Chinese herb Tripterygium wilfordii Hook F for the treatment of systemic sclerosis-associated interstitial lung disease: data from a Chinese EUSTAR Center

  • Luwei Yang
  • Qian Wang
  • Yong Hou
  • Jiuliang Zhao
  • Mengtao Li
  • Dong XuEmail author
  • Xiaofeng ZengEmail author
Original Article



To assess the efficacy and safety of the Chinese herb Tripterygium wilfordii Hook F (TwHF) for the treatment of systemic sclerosis-associated interstitial lung disease (SSc-ILD).


SSc-ILD patients who were regularly treated for more than 1 year and were currently taking a stable dose of TwHF (40–60 mg/day) or CYC (100 mg/day) were selected from the EUSTAR database of Peking Union Medical College Hospital. The efficacy of treatments was assessed by the change in pulmonary function, including the forced vital capacity (FVC) and the percentage of predicted FVC (FVC pred%).


Among the 431 patients diagnosed with SSc-ILD, 76 fulfilled the inclusion and exclusion criteria. Twenty eight patients received TwHF monotherapy, while 48 received oral CYC monotherapy. Baseline data prior to treatment did not differ significantly between the two groups. After 1 year of treatment, significant improvements in the FVC and FVC pred% were seen in both groups (P < 0.05) and the magnitude of improvement was comparable (P = 0.93). However, TwHF was only found to be effective in improving FVC and FVC pred% when administered as a maintenance therapy, but not as an induction therapy. No severe adverse events were seen in either group. Leucopenia occurred more often in the CYC group compared to the TwHF group (P = 0.034).


TwHF may be considered as a potential alternative drug for SSc-ILD patients, especially as a maintenance therapy. A prospective randomized controlled trial is necessary to further confirm these results.

Key Points

• This is the first clinical study of Tripterygium wilfordii Hook F (TwHF) in the treatment of SSc-ILD, providing a novel therapeutic option for SSc-ILD.

• TwHF shows a comparable therapeutic efficacy to CYC when treating SSc-ILD.

• TwHF has unique therapeutic advantages considering the balance of economy and safety and may be a good potential choice for maintenance therapy.


Cyclophosphamide Interstitial lung disease Systemic sclerosis Tripterygium wilfordii Hook F 


Financial support

This work was supported by the National Key Research and Development Program of China (grant no. 2016YFC0901500); Center for Rare Diseases Research, Chinese Academy of Medical Sciences, Beijing, China (grant no. 2016ZX310174-4); and a grant from CAMS Innovation Fund for Medical Sciences (CIFMS; no. 2016-I2M-1-002).

Compliance with ethical standards

The study protocol was approved by the Medical Ethics Committee of PUMCH (Beijing, China). Informed consent was not relevant as it was a retrospective study.




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  1. 1.Department of Rheumatology and Clinical Immunology, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina

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