Chinese herbal preparation reduces fragility fractures

By Laura Cowen

Herbal Fufang - a multi-herbal preparation used in traditional Chinese medicine -increases bone mineral density and reduces fragility fractures in postmenopausal women, Chinese researchers report.

The Fufang, which contained non-leguminous epimedium-derived phytoestrogen flavonoids, was associated with a more than 40% reduction in fragility fractures compared with placebo in a study of 194 postmenopausal Chinese women.

Lead researcher Wei-Ming Deng (General Hospital of Guangzhou Military Command of PLA) and colleagues explain that Fufangs have been used for centuries in China to treat bone disorders.

Recent clinical trials have suggested that these Fufangs effectively prevent osteoporosis in postmenopausal women, but data on long-term outcomes such as fractures and adverse events are lacking.

To address this, Deng and team conducted a 5-year multicenter follow-up study in which postmenopausal women (aged 47-70 years) were given an oral herbal Fufangdeveloped for prevention of postmenopausal osteoporosis (10 g/day, n=101) or placebo (n=93).

The Fufang contained several herbal compounds including Herbaepimedii, Rehmanniaglutinosa, Dioscoreabatatas, Cornusofficinalis, Cinnamomum cassia, Drynariafortunei, and Morindaofficinalis.

Both groups also received daily calcium (600 mg) and vitamin D (400 IU).

The researchers measured bone mineral density (BMD) at the distal radius using single-photon X-ray absorptiometry, and evaluated fracture incidence and potential adverse events at baseline and at 6, 12, 24, 36, 48, and 60 months.

They report in the Journal of Bone and Mineral Metabolism thatBMD increased significantly from 0.211 g/cm² at baseline to 0.284 g/cm² at the end of the study in the treatment group, whereas it decreased significantly from 0.212 g/cm² to 0.187 g/cm² in the control group.

Furthermore, fracture incidence was 4.5% in the treatment group compared with 10.4% in the control group, which equates to a significant 43% reduction in relative fracture risk among the women who received Fufang versus placebo.

There were 21 adverse events reported in each group, most commonly heartburn (n=7) among those receiving Fufang and stomach discomfort (n=7) among those receiving placebo. There were no significant changes from baseline in renal function indices or blood counts in either group.

Deng et all conclude: "In addition to the beneficial effects of oral herbal Fufang on prevention of postmenopausal bone loss, this 5-year multicenter clinical study demonstrated for the first time its potential for reduction in fragility fracture incidence."

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