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Total flavonoids from Rhizoma Drynariae (Gusuibu) for treating osteoporotic fractures: implication in clinical practice

Authors Zhang YL, Jiang JJ, Shen H, Chai Y, Wei X, Xie YM

Received 17 April 2017

Accepted for publication 19 May 2017

Published 23 June 2017 Volume 2017:11 Pages 1881—1890


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Qiongyu Guo

Yili Zhang,1 Junjie Jiang,1 Hao Shen,1 Yan Chai,2 Xu Wei,3 Yanming Xie1

1Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China; 2Department of Epidemiology, University of California, Los Angeles, CA, USA; 3Department of Scientific Research, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China

Abstract: This systematic review was performed to determine the clinical efficacy and safety of total flavonoids from Rhizoma Drynariae (TFRD) for osteoporotic fractures and to provide clear evidence for clinical practice. Eight databases were searched to identify relevant randomized controlled trials (RCTs) until December 2016. Six RCTs involving 846 patients were included. The primary outcomes included fracture recurrence and death. Meta-analysis showed that both the combination therapy and TFRD alone were better than conventional treatments in improving bone mineral density (BMD) value (weighted mean difference [WMD] =3.68, 95% confidence interval [CI]: 0.01 to 0.04, P=0.0002), (WMD =0.14; 95% CI: 0.11 to 0.16; P<0.00001), respectively, and enhancing therapeutic effect (OR =0.25; 95% CI: 0.12 to 0.51; P=0.0002). Thirty-three patients experienced adverse drug reactions (ADRs), none of the ADRs were severe and all were resolved after symptomatic treatments. Gastrointestinal symptoms were the most common ADRs in the usage of TFRD. Overall, the effect of TFRD on osteoporotic fractures was supported by improving BMD and therapeutic effect. Due to the methodological drawbacks of the included studies, the conclusions should be treated with caution for future research. Registration number: CRD42017052797.

Keywords: total flavonoids, Rhizoma Drynariae, osteoporotic fractures, systematic review, evidence-based medicine

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