More Evidence Cholesterol Drugs Reduce Fracture Risk
June 27, 2000 -- Cecilia, Angela, and Mary are three sisters who once shared
the same room, the same wardrobe, and the same enthusiasm for jacks and
porcelain-faced dolls. In July of 1999 they shared something else: All three
women, now in their 70s, had fractured bones of the spinal column. These three
diminutive sisters are among the 10 million Americans with the bone-wasting
Cecilia says she won't ever take estrogen, even though it may protect her
bones; Angela says Fosamax, a drug approved for treatment of osteoporosis,
upsets her stomach; and Mary is using Evista, one of the new, so-called
designer estrogens that doesn?t promote breast cancer and does reduce fracture
But all three of these women may someday treat their osteoporosis with a
drug that is now used to lower cholesterol, and if they do, they may also be
protecting their hearts and reducing the chance that they will have a
In less than a week, two respected medical journals -- The Lancet and
The Journal of American Medical Association (JAMA) -- each published
studies suggesting that the class of cholesterol-lowering drugs called statins
may also cut the risk of fractures by half.
A total of four human studies and one animal study have all reached that
same conclusion, a conclusion that has osteoporosis experts asking for
confirmation. Because the human studies were based on conclusions reached by
analyzing medical records, no one is willing to suggest just yet that the
statins should be used to treat osteoporosis.
But if the findings are confirmed by further research, that is just what
could happen, says Felicia Cosman, MD, clinical director of the National
Osteoporosis Foundation. She says that older women are at risk for both heart
disease and osteoporosis, so a single pill that could treat both conditions
would be a major breakthrough.
Future studies will compare how a specific statin works when compared to an
accepted treatment for osteoporosis, says Cosman. These studies are needed
because sometimes the conclusions of studies based on medical records are
disproved when tested further. Estrogen met this fate when many medical record
studies suggested that estrogen protected women from heart attacks, but
recently more research has found that when women already had heart disease,
estrogen didn't keep their disease from progressing.
JAMA editorialist Steven R. Cummings, MD, professor of medicine and
epidemiology at the University of California, San Francisco, tells WebMD that
even though he is enthusiastic about a possible role for statins, he is opposed
to using the drugs for osteoporosis before the findings are confirmed.
"It is far too early to rely upon statins for fracture protection. We've
got good, well-proven drugs that can be used for fracture prevention,"