Ipriflavone Supplementation for Osteoporosis Prevention and Treatment?

Jean-Yves Reginster, MD, PhD

Disclosures

September 04, 2002

Question

A patient has inquired about taking a calcium supplement with ipriflavone. Are there any benefits of this combination supplement vs calcium alone vis a vis osteoporosis, and are there any side effects?

Response From the Expert

Jean-Yves Reginster, MD, PhD
Director, World Health Organization Collaborating Center for Public Health Aspects of Rheumatic Diseases, University of Liège, Liège, Belgium and Head, Department of Public Health, Epidémiology and Health Economics, University of Liège, Liège, Belgium.

 

Ipriflavone is a synthetic isoflavone derivative, which has been suggested to be an inhibitor of bone resorption and a stimulator of osteoblast activity in vitro in cell cultures and in vivo in experimental models of osteoporosis. Preliminary studies, mainly performed in Italy and Japan, suggested that ipriflavone (typical dosage 600 mg/day) is able to prevent bone loss, and some data even suggested that ipriflavone may increase bone mass in postmenopausal women. However, reports of lymphocytopenia in women taking ipriflavone generated concerns regarding the safety of this particular compound. In order to investigate the effect of oral ipriflavone in prevention of postmenopausal bone loss and to assess the safety profile of long-term treatment with ipriflavone in postmenopausal osteoporotic women, a prospective, randomized, placebo-controlled 4-year study was conducted in 474 postmenopausal white women with bone mineral densities below the threshold for a diagnosis of osteoporosis, according to World Health Organization classification (ie, a bone mineral density less than 2.5 standard deviations below the young adult mean).[1] The study concluded that ipriflavone, at the daily dose of 600 mg per day, combined with calcium 500 mg per day, had no significant benefit in terms of biochemical markers of bone remodeling, bone mineral density, or fracture incidence. Furthermore, lymphocytopenia occurred in a significant number of women treated with ipriflavone. The study investigators concluded that ipriflavone could not be considered an effective or safe medication in the treatment of osteoporosis. Use of this medication should be discouraged until more data allow reconsideration of this position.

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