Objective:

2

To evaluate the benefit-risk of 3 commonly used Chinese medicine injections

Aidi Injection (ADI)

Cinobufagin Injection (CINI) and Compound Kushen Injection (CKI)

in the treatment of primary liver cancer (PLC)

so as to provide a reference for clinical decision-making.

Methods:

2

Randomized controlled trials (RCTs) of ADI

CINI and CKI in the treatment of PLC published in the databases of China National Knowledge Infrastructure

Wanfang

China Science and Technology Journal Database

SinoMed

PubMed

Cochrane Library

and Web of Science were retrieved from January 2020 to October 2022. The data of benefit and risk indicators were combined to obtain the effect value. The multi-criteria decision analysis (MCDA) model was applied to build the decision tree. The benefit value

risk value and benefit risk value of the 3 injections in PLC treatment were calculated. Monte Carlo simulation was carried out to calculate the 95% confidence interval and probability of differences among the 3 injections

so as to optimize the evaluation results.

Results:

2

A total of 71 RCTs were included. The benefit values of ADI

CINI and CKI combined with transcatheter arterial chemoembolization (TACE) were 42

38 and 36

respectively. The risk values were 42

25 and 37

respectively. The benefit risk values were 42

31 and 37

respectively. The benefit risk differences of ADI

vs

. CINI

ADI

vs

. CKI

and CKI

vs

. CINI were 11 (–0.86

17.75)

5 (–5.01

11.09)

and 6 (–1.87

12.63)

respectively. The probability that ADI superior to CINI

ADI superior to CKI

and CKI superior to CINI was 96.26%

77.27%

and 92.62%

respectively.

Conclusion:

2

Based on the results of MCDA model

CINI combined with TACE has the greatest risk in the treatment of the PLC. Considering the efficacy and safety

the possible priority of the 3 Chinese medicine injections combined with TACE in the treatment of PLC is ADI

CKI and CINI.