Preclinical pharmacological effects of epimedium-derived interventions in osteoarthritis: a systematic review and meta-analysis

Background The genus Epimedium (Berberidaceae) is widely used in traditional medicine. Recent studies indicate that its botanical metabolites (such as icariin) exhibit anti-inflammatory and chondroprotective potential in osteoarthritis (OA) models. However, a comprehensive analysis remains lacking. Methods This study was registered in PROSPERO (CRD420251143826). Chinese and English databases (PubMed, Web of Science, Embase, FMRS, VIP, CNKI, WanFang) were searched to collect preclinical controlled trials evaluating Epimedium extracts or their botanical metabolites for the treatment of OA in Murine subjects. The risk of bias was assessed using the SYRCLE tool, and data were synthesized using RevMan 5.4 and Stata 19.0. Results Thirteen studies comprising 238 Murine subjects were included. Interventions utilizing Epimedium -derived botanical metabolites significantly improved Pelletier scores and thermal paw withdrawal latency (PWL). Concurrently, they decreased the levels of serum IL-6 and MMP-13, as well as intra-articular IL-1β, IL-18, and MMP-1. Favorable pharmacological trends were also observed for serum TNF-α, intra-articular MMP-13, and the mechanical paw withdrawal threshold (PWT). Subgroup analysis identified the route of administration as a significant source of heterogeneity for intra-articular MMP-13 expression. Conclusion Botanical metabolites derived from the genus Epimedium demonstrate pharmacological potential in Murine models of OA. The underlying mechanisms likely involve attenuating the production of systemic and local inflammatory factors and ameliorating cartilage damage.