Decreased Risk of Osteoporosis Incident in Subjects Receiving Chinese Herbal Medicine for Treatment: A Retrospective Cohort Study with a Nested Case-Control Analysis

Overview

Journal Pharmaceuticals (Basel)

Publisher MDPI

Specialty Chemistry

Date 2024 Jun 27

PMID 38931412

Authors

Chieh-Tsung Yen

Hanoch Livneh

Hua-Lung Huang

Ming-Chi Lu

Wei-Jen Chen

Tzung-Yi Tsai

Affiliations

Soon will be listed here.

Abstract

Sjögren syndrome (SS) is a long-lasting inflammatory autoimmune disease that may cause diverse manifestations, particularly osteoporosis. Though usage of Chinese herbal medicine (CHM) can safely manage autoimmune disease and treatment-related symptoms, the relation between CHM use and osteoporosis risk in SS persons is not yet recognized. With that in mind, this population-level nested case-control study aimed to compare the risk of osteoporosis with and without CHM use. Potential subjects aged 20-70 years, diagnosed with SS between 2001 and 2010, were retrieved from a national health claims database. Those diagnosed with osteoporosis after SS were identified and randomly matched to those without osteoporosis. We capitalize on the conditional logistic regression to estimate osteoporosis risk following CHM use. A total of 1240 osteoporosis cases were detected and randomly matched to 1240 controls at a ratio of 1:1. Those receiving conventional care plus CHM had a substantially lower chance of osteoporosis than those without CHM. Prolonged use of CHM, especially for one year or more, markedly dwindled sequent osteoporosis risk by 71%. Integrating CHM into standard care may favor the improvement of bone function, but further well-designed randomized controlled trials to investigate the possible mechanism are needed.

Citing Articles

Adjunctive Therapy with Chinese Herbal Medicine Lowers Risk of Hearing Loss in Type 2 Diabetes Patients: Results from a Cohort-Based Case-Control Study.

Huang H, Livneh H, Yen C, Lu M, Chen W, Tsai T Pharmaceuticals (Basel). 2024; 17(9).

PMID: 39338352 PMC: 11435343. DOI: 10.3390/ph17091191.

References

Qu Z, Zhang B, Kong L, Gong Y, Feng M, Gao X . Receptor activator of nuclear factor-κB ligand-mediated osteoclastogenesis signaling pathway and related therapeutic natural compounds. Front Pharmacol. 2022; 13:1043975. PMC: 9683337. DOI: 10.3389/fphar.2022.1043975. View

Minniti G, Pescinini-Salzedas L, Minniti G, Fornari Laurindo L, Barbalho S, Sinatora R . Organokines, Sarcopenia, and Metabolic Repercussions: The Vicious Cycle and the Interplay with Exercise. Int J Mol Sci. 2022; 23(21). PMC: 9655425. DOI: 10.3390/ijms232113452. View

Kanis J, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby A . The components of excess mortality after hip fracture. Bone. 2003; 32(5):468-73. DOI: 10.1016/s8756-3282(03)00061-9. View

Perera S, Ma L, Punwaney R, Ramachandran S . Clinical and Cost Burden of Primary Sjögren's Syndrome: Descriptive Analysis Using a US Administrative Claims Database. J Health Econ Outcomes Res. 2022; 5(2):150-161. PMC: 9090467. DOI: 10.36469/9807. View

Weitzmann M . Bone and the Immune System. Toxicol Pathol. 2017; 45(7):911-924. PMC: 5749254. DOI: 10.1177/0192623317735316. View

Chen H, Lai J, Yu M, Chen C, Hsieh Y, Hsu Y . Traditional Chinese Medicine in Patients With Primary Sjogren's Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Front Med (Lausanne). 2021; 8:744194. PMC: 8505713. DOI: 10.3389/fmed.2021.744194. View

Cortes-Vieyra R, Silva-Garcia O, Gomez-Garcia A, Gutierrez-Castellanos S, Alvarez-Aguilar C, Baizabal-Aguirre V . Glycogen Synthase Kinase 3β Modulates the Inflammatory Response Activated by Bacteria, Viruses, and Parasites. Front Immunol. 2021; 12:675751. PMC: 8129516. DOI: 10.3389/fimmu.2021.675751. View

Kuo P, Lin T, Chang Y, Hou T, Hsu H, Lin S . Primary Sjogren syndrome increases the risk of bisphosphonate-related osteonecrosis of the jaw. Sci Rep. 2021; 11(1):1612. PMC: 7810724. DOI: 10.1038/s41598-020-80622-5. View

Yasui T, Yamada M, Uemura H, Ueno S, Numata S, Ohmori T . Changes in circulating cytokine levels in midlife women with psychological symptoms with selective serotonin reuptake inhibitor and Japanese traditional medicine. Maturitas. 2009; 62(2):146-52. DOI: 10.1016/j.maturitas.2008.12.007. View

10.

Austin P . A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003. Stat Med. 2007; 27(12):2037-49. DOI: 10.1002/sim.3150. View

11.

Qin B, Wang J, Yang Z, Yang M, Ma N, Huang F . Epidemiology of primary Sjögren's syndrome: a systematic review and meta-analysis. Ann Rheum Dis. 2014; 74(11):1983-9. DOI: 10.1136/annrheumdis-2014-205375. View

12.

Huang S, Gau S, Huang J, Wu W, Cheng-Chung Wei J . Increased Risk of Hypothyroidism in People with Asthma: Evidence from a Real-World Population-Based Study. J Clin Med. 2022; 11(10). PMC: 9146804. DOI: 10.3390/jcm11102776. View

13.

An S, Han F, Hu Y, Liu Y, Li J, Wang L . Curcumin Inhibits Polyethylene-Induced Osteolysis via Repressing NF-κB Signaling Pathway Activation. Cell Physiol Biochem. 2018; 50(3):1100-1112. DOI: 10.1159/000494537. View

14.

Thurtle E, Grosjean A, Steenackers M, Strege K, Barcelos G, Goswami P . Epidemiology of Sjögren's: A Systematic Literature Review. Rheumatol Ther. 2023; 11(1):1-17. PMC: 10796897. DOI: 10.1007/s40744-023-00611-8. View

15.

Ding D, Yan J, Feng G, Zhou Y, Ma L, Jin Q . Dihydroartemisinin attenuates osteoclast formation and bone resorption via inhibiting the NF‑κB, MAPK and NFATc1 signaling pathways and alleviates osteoarthritis. Int J Mol Med. 2021; 49(1). PMC: 8589459. DOI: 10.3892/ijmm.2021.5059. View

16.

Shih C, Liao C, Su Y, Tsai C, Lin J . Gender differences in traditional Chinese medicine use among adults in Taiwan. PLoS One. 2012; 7(4):e32540. PMC: 3335160. DOI: 10.1371/journal.pone.0032540. View

17.

Deyo R, Cherkin D, Ciol M . Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992; 45(6):613-9. DOI: 10.1016/0895-4356(92)90133-8. View

18.

Aljefree N, Almoraie N, Althaiban M, Hanbazaza M, Wazzan H, Shatwan I . Gender differences in knowledge, attitudes, and practices with respect to type 1 diabetes among Saudi public-school teachers. BMC Public Health. 2023; 23(1):118. PMC: 9847176. DOI: 10.1186/s12889-023-15043-w. View

19.

Sharma A, Jagga S, Chakraborty C, Lee S . Fibroblast-Like-Synoviocytes Mediate Secretion of Pro-Inflammatory Cytokines via ERK and JNK MAPKs in Ti-Particle-Induced Osteolysis. Materials (Basel). 2020; 13(16). PMC: 7476030. DOI: 10.3390/ma13163628. View

20.

Doss H, Samarpita S, Ganesan R, Rasool M . Ferulic acid, a dietary polyphenol suppresses osteoclast differentiation and bone erosion via the inhibition of RANKL dependent NF-κB signalling pathway. Life Sci. 2018; 207:284-295. DOI: 10.1016/j.lfs.2018.06.013. View