Pharmacological effects of Salvia miltiorrhiza-derived interventions on osteoporosis in animal models: a systematic review and meta-analysis.

PURPOSE: This 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.

METHODS

A 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.

RESULTS

Salvia 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.

CONCLUSION

Salvia 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.