EFFECT OF CHINESE HERBAL MEDICINE COMBINED WITH CONVENTIONAL ANTI-OSTEOPOROTIC MEDICATION ON FRACTURE RISK IN OLDER ADULTS WITH OSTEOPOROSIS: A RETROSPECTIVE COHORT STUDY
Author(s)
Shuo Zhang, BsC1, Mengyao Xue, BsC1, Nan Peng, PhD2, Ruolan Wei, BsC1, guoxian Lu, BsC1, Dongning Yao, BsC1;
1Nanjing Medical University, Nanjing, China, 2School of Pharmaceutical Science and Technology,Tianjin University, Tianjin, China
1Nanjing Medical University, Nanjing, China, 2School of Pharmaceutical Science and Technology,Tianjin University, Tianjin, China
OBJECTIVES: To assess the association between concomitant Chinese herbal medicine (CHM) use and fracture risk among patients with osteoporosis receiving Western standard therapy (WST).
METHODS: This retrospective cohort study used a provincial healthcare database in Eastern China (2019-2024) with a new-user design. Adults aged 50 years or older who have diagnosed with osteoporosis were included. Patients were followed until the occurrence of Paget’s disease, malignant tumors, death, loss to follow-up, or October 29, 2024, whichever occurred first. Eligible patients were categorized into two cohorts according to whether they had been exposed to CHM at their first prescription after osteoporosis diagnosis. Propensity score matching was performed to adjust for known covariates. Cox proportional hazards models were then applied to further adjust for residual imbalances and to estimate hazard ratios for hip, nonvertebral (NV; includes hip, humerus, pelvis, radius/ulna, other femur), non-hip nonvertebral (NHNV), hospitalized vertebral (HV), and major osteoporotic (MOP; consisting of NV and HV) fractures
RESULTS: A total of 112,965 patients were included in the analysis, with 3,619 in the WST/CHM group and 109,346 in the WST group. Cox proportional hazards analysis revealed no significant association between exposure and the risk of any fracture type: MOP (HR=1.17; 95% CI, 0.90-1.51; P=0.232), hip fracture (HR=1.22; 95% CI, 0.66-2.23; P=0.529), nonvertebral fracture (HR=1.04; 95% CI, 0.71-1.53; P=0.826), non-hip nonvertebral fracture (HR=0.92; 95% CI, 0.58-1.47; P=0.738), and hospitalized vertebral fracture (HR=1.27; 95% CI, 0.86-1.86; P=0.225).
CONCLUSIONS: In this large retrospective cohort study of older adults with osteoporosis, combined use of WST and CHM was not associated with a reduced risk of hip, hospitalized vertebral, nonvertebral, non-hip nonvertebral or major osteoporotic fractures. These findings suggest that, in routine clinical practice, CHM may not confer additional fracture-preventive benefits beyond standard pharmacologic treatment.
METHODS: This retrospective cohort study used a provincial healthcare database in Eastern China (2019-2024) with a new-user design. Adults aged 50 years or older who have diagnosed with osteoporosis were included. Patients were followed until the occurrence of Paget’s disease, malignant tumors, death, loss to follow-up, or October 29, 2024, whichever occurred first. Eligible patients were categorized into two cohorts according to whether they had been exposed to CHM at their first prescription after osteoporosis diagnosis. Propensity score matching was performed to adjust for known covariates. Cox proportional hazards models were then applied to further adjust for residual imbalances and to estimate hazard ratios for hip, nonvertebral (NV; includes hip, humerus, pelvis, radius/ulna, other femur), non-hip nonvertebral (NHNV), hospitalized vertebral (HV), and major osteoporotic (MOP; consisting of NV and HV) fractures
RESULTS: A total of 112,965 patients were included in the analysis, with 3,619 in the WST/CHM group and 109,346 in the WST group. Cox proportional hazards analysis revealed no significant association between exposure and the risk of any fracture type: MOP (HR=1.17; 95% CI, 0.90-1.51; P=0.232), hip fracture (HR=1.22; 95% CI, 0.66-2.23; P=0.529), nonvertebral fracture (HR=1.04; 95% CI, 0.71-1.53; P=0.826), non-hip nonvertebral fracture (HR=0.92; 95% CI, 0.58-1.47; P=0.738), and hospitalized vertebral fracture (HR=1.27; 95% CI, 0.86-1.86; P=0.225).
CONCLUSIONS: In this large retrospective cohort study of older adults with osteoporosis, combined use of WST and CHM was not associated with a reduced risk of hip, hospitalized vertebral, nonvertebral, non-hip nonvertebral or major osteoporotic fractures. These findings suggest that, in routine clinical practice, CHM may not confer additional fracture-preventive benefits beyond standard pharmacologic treatment.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO139
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment, Comparative Effectiveness or Efficacy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)