Efficacy of Chinese patent medicine for primary osteoporosis: A network meta-analysis

Background and purpose: Chinese patent medicines (CPMs) have gained increasing attention for the treatment of primary osteoporosis (POP), but there is a lack of high-quality evidence regarding their efficacy. We conducted a network meta-analysis that considered both direct and indirect comparisons to assess and rank the efficacy and safety of CPMs for POP. Methods: Seven electronic databases were searched from their inception to May 2020. A random effects model was applied within a frequentist framework. Results: Thirty-eight studies with 16 kinds of medicines (13 CPMs, 3 Western medicines) and 3,941 patients were included in this study. This study showed that Jintiange capsule was the most efficacious for increasing the L2-L4 average bone mineral density (BMD) and that Zuogui Wan was the most efficacious for increasing the femoral neck BMD. Compared with calcium, Gusongjiangu Wan (RR =10.04, 95% CI 1.36-74.32, p = 0.008), Gushukang granules (RR = 12.63, 95% CI 2.02-78.99, p = 0.015) and Xianling Gubao capsule (RR = 6.06, 95% CI 1.38-26.65, p = 0.0003) had fewer adverse reactions. Conclusion: In the treatment of POP, Jintiange capsule and Zuogui Wan are effective CPMs for improving the BMD of the lumbar spine and femoral neck, respectively.

Automated summary

This study conducted a network meta-analysis to assess and rank the efficacy and safety of Chinese patent medicines for primary osteoporosis, with Jintiange capsule and Zuogui Wan being identified as the most effective medicines for improving bone mineral density in the lumbar spine and femoral neck.