Ethnopharmacological relevance: Derris scandens (Roxb.) Benth. has been used as active ingredient in Thai
traditional medicine recipes for pain treatment. Dry stem powder and ethanolic extract also recommended
in Thailand National List of Essential Medicines (NLEMs) for musculoskeletal pain treatment
as herbal medicine. However, no summarization of clinical effect and safety has been evaluated.
Objective: Our study aimed to determine the clinical effects and safety of D. scandens for musculoskeletal
pain treatment compared with standard regimen, nonsteroidal anti-inflammatory drugs (NSAIDs).
Methods: International and Thai databases were searched from inception through August 2015. Comparative
randomized controlled trials investigating oral D. scandens for musculoskeletal pain were included.
Outcomes of interest included level of pain and adverse event. Mean changes of the outcomes
from baseline were compared between D. scandens and NSAIDs by calculating mean difference.
Results: From 42 articles identified, 4 studies involving a total of 414 patients were included for efficacy
analysis. The effects of oral D. scandens on reducing pain score were no different from those of nonsteroidal
anti-inflammatory drugs at any time points (3, 7, 14 days and overall). The overall pain reduction
in the D. scandens group was not inferior to treatment with NSAIDs (weighted mean difference
0.06; 95% CI: 0.20, 0.31) without evident of heterogeneity (I2¼0.00%, p¼0.768). When compared, the
adverse events (AEs) of D. scandens showed no different relative risk with NSAIDs. The major adverse
events were gastrointestinal symptoms