Systematic review and meta-analysis of Salvia miltiorrhiza for osteoporosis in animal models
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Key Takeaway
Consider that Salvia miltiorrhiza may improve bone parameters in animal models, but human applicability remains uncertain.
This is a systematic review and meta-analysis of preclinical evidence on Salvia miltiorrhiza-derived interventions for osteoporosis, synthesizing data from 24 eligible animal studies. The authors report a pooled effect size for bone mineral density (BMD) with a standardized mean difference of 1.95 (95% CI 1.48 to 2.42, p < 0.000001), indicating a significant increase. The review also found significant improvements in trabecular structure, biomechanical properties, and bone turnover markers, including increased procollagen type I N-terminal propeptide (PINP) and decreased tartrate-resistant acid phosphatase (TRACP) and alkaline phosphatase (ALP).
The authors acknowledge key limitations, including the limited translational validity of animal models and that these models do not fully reflect human pharmacokinetics or disease complexity. Safety data were not reported in the included studies. The review does not report a comparator, follow-up duration, or absolute numbers for outcomes.
Practice relevance is not reported, and the authors caution that implications for human application should not be considered without further well-designed preclinical and translational studies. The certainty of evidence is low due to the preclinical nature of the data.
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View Original Abstract ↓
PurposeThis systematic review and meta-analysis aimed to evaluate the pharmacological effects of Salvia miltiorrhiza-derived interventions, including extracts and bioactive metabolites, in treating osteoporosis in animal models.MethodsA comprehensive literature search was conducted across seven Chinese and English databases. Studies included in the analysis were randomized controlled trials (RCTs) assessing the effects of Salvia miltiorrhiza-derived extracts or bioactive metabolites on osteoporosis in animal models. Data from 24 eligible studies were extracted, including information on bone density, bone morphology, and biochemical markers. The risk of bias was assessed using the SYRCLE’s risk of bias tool, and statistical analyses were performed using Stata and Review Manager.ResultsSalvia miltiorrhiza-derived interventions significantly improved Bone Mineral Density (BMD) (SMD = 1.95, 95% CI = 1.48 to 2.42, p < 0.000001), trabecular structure, and biomechanical properties. Salvia miltiorrhiza-derived interventions also modulated key bone metabolism markers, including increased procollagen type I N-terminal propeptide (PINP) and decreased tartrate-resistant acid phosphatase (TRACP) and alkaline phosphatase (ALP) levels, indicating improved osteogenesis and reduced bone resorption. Subgroup analyses revealed that the ovariectomy (OVX) model showed the most significant effects, with more favorable outcomes in the higher-dose subgroup and in studies with intervention durations of less than 12 weeks.ConclusionSalvia miltiorrhiza-derived interventions demonstrated significant bone-protective effects in osteoporosis animal models. However, these findings should be interpreted within the context of preclinical evidence, as animal models have limited translational validity and do not fully reflect human pharmacokinetics or disease complexity. Further well-designed preclinical and translational studies are needed before any implications for human application can be considered.
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