Abstract

Background: Menopause is associated with detrimental changes in turnover of bone and cartilage and a variety of symptoms with negative impact on the quality of life. Naturally occurring isoflavones from Radix Pueraria lobata, Kudzu root, may possess chondroprotective and symptom-relieving properties, but efficacy and safety of dosing and dose frequencies required for pharmacological action is unclear. Purpose: This clinical trial evaluates the efficacy on bone and cartilage turnover, menopausal symptoms, and safety of five dose regimens of Kudzu root extract administered either once, twice or three times daily in women with at least mild menopausal symptoms. Materials and Methods: Fifty postmenopausal women were randomized equally into five different dose regimen groups of Kudzu root extract in a four-week, parallel group, open-label, single-center, exploratory study design. Biomarkers CTX-I and CTX-II reflecting bone and cartilage degradation, respectively, were assessed in blood samples and 24-h urine samples. Change from baseline in the Menopause Rating Scale (MRS) and subscales was evaluated. Safety endpoints were frequency of adverse events, changes in hematology and safety chemistry data, vital signs and electrocardiogram. Results: Fifty women (Age 54.2 years, SD: 2.9) were randomized. After 4 weeks of treatment, biomarkers of bone resorption and cartilage degradation were statistically significantly reduced from baseline levels in the group receiving two capsules three times a day, serum/urine CTX-I (−18.4%, 95% CI: −8.1 to −27.5, p = 0.001/−34.2%, 95% CI: −21.6 to −44.7, p < 0.0001), urine CTX-II (−17.4% 95% CI: −2.5 to −30.0, p = 0.02). The observed effects were consistent across study groups but appeared to favour three times daily dosing. Four weeks of treatment led to statistically significant reductions in the MRS Total Score (p < 0.0001–0.03) in four out of five treatment groups. Kudzu root extract was well tolerated in all dose regimens, and no serious adverse events were reported. Conclusion: The results indicate that Kudzu extract may possess beneficial effects on bone and cartilage health and may be a promising natural alternative to existing treatments for menopausal symptoms. Kudzu root extract was well tolerated for short-term treatment of mild to severe menopausal symptoms in women in all tested doses and dose frequencies.

Highlights

  • Menopause marks an end of the female fertile period as the result of significantly reduced ovarian production of estrogen and progesterone

  • Women may experience climacteric symptoms with a negative impact on the quality of life (Whiteley et al, 2013) as well as changes in tissue turnover. This directly impactis bone turnover, and may influence joint health e.g. by inducing, or worsening the progression of existing conditions such as osteoarthritis and osteoporosis; both conditions being more common in women after menopause (Bay-Jensen et al, 2012)

  • The management of post-menopausal osteopenia and joint conditions is limited to the established medical treatment in manifest conditions of osteoporosis and osteoarthritis

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Summary

Introduction

Menopause marks an end of the female fertile period as the result of significantly reduced ovarian production of estrogen and progesterone. Women may experience climacteric symptoms with a negative impact on the quality of life (Whiteley et al, 2013) as well as changes in tissue turnover This directly impactis bone turnover, and may influence joint health e.g. by inducing, or worsening the progression of existing conditions such as osteoarthritis and osteoporosis; both conditions being more common in women after menopause (Bay-Jensen et al, 2012). Systemic hormone therapy is associated with various adverse effects including increased risk of thromboembolic events, breast cancer and a possible association with ovarian cancer, as well as increased risk of endometrial cancer (Pinkerton et al, 2017). This indicates a substantial need for alternatives for the management of menopausal symptoms and associated bone and joint conditions. Purpose: This clinical trial evaluates the efficacy on bone and cartilage turnover, menopausal symptoms, and safety of five dose regimens of Kudzu root extract administered either once, twice or three times daily in women with at least mild menopausal symptoms

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Conclusion

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