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Red sage as an osteoporosis ‘treatment?’ Benefits shown in six mice, not people

New osteoporosis treatment uses traditional Chinese herb to prevent bone loss

Our Review Summary

This news release describes research showing that a chemical compound in the red sage plant blocks an enzyme that promotes the breakdown of collagen in bones. This might be an interesting lead for scientists, but the release prematurely dubs the plant a “treatment” for osteoporosis and doesn’t mention that effects observed in cells in a lab dish or in mice might not translate to a benefit for human patients. The result people care about — reducing fractures — isn’t brought up. The news release’s assertion that this herb “might hold the key to a new osteoporosis therapy that could prevent bone loss without causing side effects” might raise false hopes.

 

Why This Matters

The use of red sage to treat osteoporosis in traditional Chinese medicine has inspired researchers. A 2014 review found 36 clinical trials using the plant, also called danshen or salvia miltiorrhiza, which it says constituted “more than 30 percent of all herbal clinical trials successfully targeting osteoporosis.”

Osteoporosis is common, affecting 5.1 percent of men and 24.5 percent of women over the age of 65, according to the CDC. The condition increases the risk of bone fractures, which can lead to pain and disability. But isolating a plant compound and testing it in the lab are preliminary steps, and there’s no guarantee that red sage can safely prevent bone fractures. News releases should refrain from predicting outcomes for human beings based on studies in lab dishes and mice.

Criteria

Does the news release adequately discuss the costs of the intervention?

Not Satisfactory

There’s no mention of cost. HealthNewsReview.org found a bottle of 60 capsules of 500-mg red sage online for $19.95. Of course, that could be far from the cost of an actual treatment should one be developed, since we don’t know the cost of processing, marketing, and quality assurance.

Does the news release adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The release says the red sage compound was tested “in human and mouse bone cells and a mouse model. They found that it prevented bone loss and increased the bone mineral density of the mice treated with the compound by 35 per cent, when compared with the control group.”

The release should have mentioned that benefits shown in mice don’t necessarily translate to humans. The release doesn’t provide any results relating to the chemical compound’s effect on the cells that were tested.

Further, bone mineral density doesn’t precisely measure fracture risk, which is what matters to patients. None of these important caveats are mentioned.

Does the news release adequately explain/quantify the harms of the intervention?

Not Satisfactory

No potential harms are mentioned. According to WebMD, red sage: “can cause some side effects, including itching, upset stomach, and reduced appetite. There is some concern that it might also cause drowsiness, dizziness, and a blood condition called thrombocytopenia.” The safety of long-term use hasn’t been rigorously studied.

Does the news release seem to grasp the quality of the evidence?

Not Satisfactory

The release doesn’t tell us about the clinical trials other than that the compound was tested in “human and mouse bone cells and a mouse model.”

We aren’t told how many cell samples were included in the various tests. The published study states that in one trial, the compound was given to six “12-week-old ovariectomized (OVX) mice for 3 months.” Ovarized means the ovaries had been removed.

This is very preliminary research and the limitations of animal research and small samples should have been mentioned in the release.

Does the news release commit disease-mongering?

Satisfactory

The news release states that osteoporosis “is a global health problem that will affect one out of three women and one out of five men worldwide.” We don’t know where these numbers came from and they appear to be on the high side. On the other hand, osteoporosis is common. One study put osteoporosis prevalence in nine industrialized countries at 9 to 38 percent of women and 1 to 8 percent of men ages 50 and over. In these countries, osteoporosis was found to affect up to 49 million people.

Does the news release identify funding sources & disclose conflicts of interest?

Satisfactory

On EurekAlert!, where the news release is hosted, we’re told that the study was funded by Canadian Institutes of Health Research grants and a Canada Research Chair award. We encourage news releases to include funders in the body of the release, too.

The authors listed no conflicts of interest in the published study.

Does the news release compare the new approach with existing alternatives?

Not Satisfactory

Existing treatments for osteoporosis including prescription drugs such as alendronate, risedronate, zoledronic acid and denosumab, as well as exercise and dietary changes, were not mentioned. The news release mentions “a multi-billion-dollar pharmaceutical industry dedicated to finding treatments to stop its progression,” implying that red sage could constitute a cost-effective alternative, but it doesn’t delve into the effectiveness of current treatment options.

Does the news release establish the availability of the treatment/test/product/procedure?

Satisfactory

The news release says the red sage is “widely used” in traditional Chinese medicine. That conveys that it’s easy to get.

Does the news release establish the true novelty of the approach?

Satisfactory

The news release states that a compound in red sage may block an enzyme called Cathespin K without the negative effects exhibited by osteoporosis drugs. It also notes that the study builds on the researcher’s previous work that looked at red sage as a treatment for “bone ailments.” It quotes a researcher saying: “All clinical trials to date have failed due to side effects ranging from stroke, skin fibrosis and cardiovascular issues. We’ve found a way to block CatK only in one tissue that we think will prevent these other negative effects.” This research seems to be unique in that respect.

Does the news release include unjustifiable, sensational language, including in the quotes of researchers?

Not Satisfactory

To call this a “treatment” as this news release and its headline does is premature.

Total Score: 4 of 10 Satisfactory

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