Combination effects of herbal and western medicines on osteoporosis in rheumatoid arthritis: systematic review and meta-analysis

Kwon, Do Young; Gu, Ji Hyang; Oh, Minseok; Lee, Eunjung

doi:10.3389/fphar.2023.1164898

Cited by 2 publications

References 60 publications

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Risk factors for incident fragility fractures in patients with rheumatoid arthritis: An cohort study based on a nation-wide prospective registry

Hou,

Jin,

Duan

et al. 2023

Preprint

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Objective To identify the risk factors associated with incident fragility fractures in Chinese patients with rheumatoid arthritis (RA). Methods This study was based on the Chinese Registry of rhEumatoiD arthrITis (CREDIT), a nation-wide prospective registry. For each patient with incident fragility fracture, 20 control patients with matched follow-up duration (with < 1 month difference) were randomly selected for analysis using multivariable logistic regression analysis. Results are shown as odds ratio (OR) and 95% confidence interval (CI). Results A total of 11564 patients were screened. Incident fragility fracture occurred in 32 patients (27 women) patients during the median follow-up of 24.5(10.3, 31.8)months. In comparison to the control patients (n = 642; 534 women), patients who developed fragility fractures had older age, higher rate of menopause, longer disease duration, higher rate of morning stiffness, higher number of swollen joints and higher DAS28 CRP at the baseline. The cases also had lower use rate for glucocorticoid, csDMARDs, and calcium-vitamin D supplementation. In multivariable logistic regression, incident fragility fracture was associated with older age (OR: 1.006 per year, 95%CI: 1.001, 1.011), longer disease duration (OR: 1.006 per year, 95%CI: 1.001, 1.011), menopause (OR: 28.411, 95%CI: 3.154, 255.935), and no calcium-vitamin D supplementation (OR: 4.505, 95%CI: 1.414, 14.289). Conclusion Risk factors for incident fragility fracture in RA patients included older age, longer disease duration, menopause and no calcium-vitamin D supplementation.

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Risk factors for incident fragility fractures in patients with rheumatoid arthritis: An cohort study based on a nation-wide prospective registry

Hou,

Jin,

Duan

et al. 2023

Preprint

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Additional effects of herbal medicine combined with bisphosphonates for primary osteoporosis: a systematic review and meta-analysis

Yoo,

Kim,

Park

et al. 2024

Front. Pharmacol.

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BackgroundOsteoporosis (OP) is a significant medical issue associated with population aging. Recent research on herbal medicines (HMs) for OP has been increasing, with these therapies sometimes used in conjunction with bisphosphonates (BPs), the standard treatment for OP. We conducted a systematic review and meta-analysis to evaluate the effects of combining HMs with BPs on improving bone mineral density (BMD) in patients with primary OP.MethodsWe searched nine databases—PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure Wanfang, KISS, Kmbase, Science On, and Oasis—up to 31 August 2023. We selected randomized controlled trials (RCTs) comparing BMD between HMs plus BPs and BPs alone in primary OP. A meta-analysis with BMD as the primary outcome was performed using RevMan version 5.4. Study quality and evidence certainty were assessed through Cochrane’s risk of bias2 and GRADE.ResultsOut of 43 RCTs involving 4,470 participants (mean age 65.8 ± 6.6 years), 35 RCTs with 3,693 participants were included in the meta-analysis. The combination of HMs and BPs was found to be more effective in improving BMD compared to BPs alone, with improvements of 0.10 g/cm2 at the lumbar spine (33 RCTs, 95% CI: 0.07–0.12, p < 0.001, I2 = 93%) and 0.08 g/cm2 at the femoral neck (20 RCTs, 95% CI: 0.05–0.12, p < 0.001, I2 = 94%), though this result was associated with high heterogeneity, high risk of bias, and very low certainty of evidence.ConclusionOur data suggest the possibility that combining HMs with BPs may improve BMD in primary OP more effectively than using BPs alone. However, the results should be interpreted with caution due to the high heterogeneity and low quality of the studies included in the review. Therefore, further well-designed RCTs are needed to confirm these findings.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023392139.

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Combination effects of herbal and western medicines on osteoporosis in rheumatoid arthritis: systematic review and meta-analysis

Cited by 2 publications

References 60 publications

Risk factors for incident fragility fractures in patients with rheumatoid arthritis: An cohort study based on a nation-wide prospective registry

Risk factors for incident fragility fractures in patients with rheumatoid arthritis: An cohort study based on a nation-wide prospective registry

Additional effects of herbal medicine combined with bisphosphonates for primary osteoporosis: a systematic review and meta-analysis

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