Evidence map›Paper›PMID 40358648›Full record

ArticleBreast cancer research and treatment2025

Association between Extract Rheum rhaponticum 731 (ERr 731) prescription and subsequent breast cancer.

Peter W Heger, Dirk Hotz, Matthias Kalder, Karel Kostev

Abstract readComparative Study
In one paragraph

Article in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. The special extract ERr 731Frontiers in pharmacology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Peter W HegerHealth Research Services GmbH, Hofaeckerstr. 14, 76698, Ubstadt-Weiher, Germany.
Dirk HotzHealth Research Services GmbH, Hofaeckerstr. 14, 76698, Ubstadt-Weiher, Germany.
Matthias KalderDepartment of Gynecology and Obstetrics, Philipps-University, Marburg, Germany.
Karel KostevDepartment of Gynecology and Obstetrics, Philipps-University, Marburg, Germany. kostev@staff.uni-marburg.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe special extract ERr 731 from the roots of rhapontic rhubarb has been prescribed for women with menopausal symptoms for more than 30 years. The aim of the present study is to evaluate the association between ERr 731 therapy and subsequent breast cancer in women in a real-world setting. ERr 731 users were compared to women without this therapy as well as women receiving hormone therapy.

methodsThis retrospective cohort study included data of women treated by 260 office-based gynecologists in Germany who received a prescription for ERr 731 between 1993 and 2022 (IQVIA Disease Analyzer database). These women were matched to women without ERr 731 prescriptions as well as women with hormone replacement therapy (HRT) prescriptions (1:3) using nearest neighbor propensity scores. A univariate Cox regression analysis was conducted to evaluate the associations between ERr 731 prescription and breast cancer risk compared to women without ERr 731 prescription and women with HRT prescriptions.

resultsA total of 5,686 women with versus 17,058 women without ERr 731 prescription were available for the first analysis, and 2,616 women with ERr 731 prescription (a proportion of the 5,686 women used in the first analysis) and 7,848 women with HRT prescriptions for the second (average age 52-53 years). ERr 731 was not associated with an increased risk of breast cancer diagnosis when the group of women with ERr 731 prescription was compared to women without (OR: 1.01, 95% CI: 0.81-1.26) or to that of women with HRT prescription ((OR: 0.96, 95% CI: 0.69-1.33). No associations were observed in age-stratified analyses or in women with and without menopausal or other perimenopausal disorders.

conclusionThe present study provides strong evidence that ERr 731 is not associated with an increased risk of breast cancer diagnosis compared to both non-users and HRT users. Given its favorable safety profile, ERr 731 may represent a viable alternative to HRT, particularly for women concerned about breast cancer risk.

Indexed as

Breast NeoplasmsHormone Replacement TherapyMenopausePlant ExtractsAdolescentAdultCase-Control StudiesDrug PrescriptionsElectronic Health RecordsFemaleGermanyHumansIncidenceMiddle AgedPlant RootsRetrospective StudiesERr 731Plant ExtractsAssociationBreast cancerERr 731GermanyPhytotherapyRhapontic rhubarb

Identifiers

PMID40358648
PMCPMC12086110

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.