Therapeutic efficacy of celastrol in experimental polyarthritis: insights from a meta-analysis of in vivo studies

Celastrol, a bioactive compound derived from Tripterygium wilfordii, has shown potent anti-inflammatory and immunomodulatory properties. Preclinical studies suggest its therapeutic potential in rheumatoid arthritis (RA); however, a comprehensive quantitative synthesis is lacking. This meta-analysis aimed to systematically evaluate the efficacy of celastrol in animal models of rheumatoid arthritis and to identify its impact on clinical, histological, and biochemical outcomes. A systematic search was conducted across PubMed, Science Direct, and Google scholar for in vivo studies evaluating celastrol in RA animal models. Data were extracted on paw swelling, arthritis scores, histopathological changes, and inflammatory cytokine levels. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Publication bias was assessed using funnel plots. A total of 21 studies were included. Celastrol significantly reduced paw swelling (SMD = − 0.92, 95% CI − 1.26, − 0.58), arthritis scores (SMD = −2.59, 95% CI − 3.03, − 2.15), and pro-inflammatory cytokines such as TNF-α and IL-6. Histological assessments also indicated reduced joint damage and inflammatory cell infiltration. Funnel plots suggested low risk of publication bias. Celastrol exhibits significant therapeutic effects in preclinical RA models by attenuating inflammatory and oxidative stress markers. These findings support celastrol potential as a promising candidate for RA treatment, warranting further investigation in clinical settings.