A Comparison of the Risk of Fracture in Rheumatoid Arthritis Patients with and without Receiving Chinese Herbal Medicine

Abstract

Objective Patients with rheumatoid arthritis (RA) often suffer from bone complications due to persistent joint inflammation, especially incident fracture. Nowadays, Chinese herbal medicines (CHMs) have provided safe and effective therapy for treating skeletal conditions, but it is unclear whether CHMs can prevent fracture onset among RA individuals. This study aimed to determine the association between the use of CHMs and the risk of fracture among them. Methods This retrospective, population-based study retrieved administrative health data from the Taiwan National Health Insurance (NHI) database to identify patients with newly diagnosed RA between 2000 and 2009. Of the 6178 incident RA patients, 2495 matched pairs of CHMs users and non-CHMs users were identified by propensity score matching. Enrollees with hip fractures prior to RA onset were excluded. Included subjects were followed until the end of 2013. Incidence and adjusted hazard ratios (HR) of new-onset bone fracture in the multivariable Cox proportional hazard model were measured with 95% confidence interval (CI). Results Fracture incidence was lower in CHMs users than in the comparison cohort (26.91 vs 32.94 per 1000 person-years, respectively), with an adjusted HR of 0.82 (95% CI: 0.73–0.92). Subjects receiving CHMs for more than 2 years had a much lower risk of fracture onset by more than 50%. Some CHMs prescriptions (Yan Hu Suo, Bei Mu, Da Huang, Dang Shen, Fu-Zi, Shu-Jing-Huo-Xue-Tang, Dang-Gui-Nian-Tong-Tang, Jia-Wei-Xiao-Yao-San, Gan-Lu-Yin, and Gui-Zhi-Shao-Yao-Zhi-Mu-Tang) were associated with reduced fracture risk. Conclusion Adding CHMs to routine treatment was found to be related to lower fracture risk in RA patients.

Traditional Chinese Medicine Is Associated with Reduced Risk of Readmission in Rheumatoid Arthritis Patients with Anemia: A Retrospective Cohort Study

“…TCM recently has attracted elevating attention from clinicians and relevant researchers for its role in the treatment of RA [ 29 ]. Former research has uncovered that the risk of fracture has been reduced by more than 50% in RA patients undergoing over 2 years of TCM treatment [ 30 ]. Chiu et al noted that compared with the non-TCM group, the prognosis of the circulatory system of inpatients was favorable in the auxiliary TCM group, accompanied by two-thirds of reductions in the readmission rate of circulatory system events [ 31 ].…”

Hypoxia inducible factor-1α related mechanism and TCM intervention in process of early fracture healing

“…In the process of fracture treatment and healing, Drynariae Rhizoma (Gusuibu in Chinese) , Rehmanniae Radix (Dihuang in Chinese) , Epimedii Folium (Yinyanghuo in Chinese), Angelicae Sinensis Radix (Danggui in Chinese) and so on are the most commonly used. These herbs often play the role of activating blood circulation, removing blood stasis, dredging channels and collaterals, relieving pain, strengthening tendons and bones, and improving microcirculation ( Liao et al, 2021 , Xu et al, 2019 ). From this, it can be seen that TCM can be used for the treatment of fractures, however, why can TCM treat fracture?…”

An intersectional analysis of LncRNAs and mRNAs reveals the potential therapeutic targets of Bi Zhong Xiao Decoction in collagen-induced arthritis rats

“…Traditional Chinese medicine (TCM) has been employed to treat RA for thousands of years [4][5][6]. These ancient therapies are still in use and development and have the advantages of low toxicity, relatively low price, and few side effects [7][8][9].…”