More Evidence Cholesterol Drugs Reduce Fracture Risk
On their own in study after study, statins have a stellar track record.
Clinical evidence suggests that statins can prolong life in the face of heart
attack, reduce the risk of stroke, and lower blood pressure. Nonetheless,
Philip S. Wang, MD, DrPH, lead author of one of the JAMA studies, says
it is far too soon to "consider [statins] as the one-pill
Yet, the prospect is attractive, and even as he urges restraint, Cummings
says that UCSF is in the planning stages of a study on using statins for
osteoporosis. He says the trial is being planned with the assistance of Gregory
Mundy, MD, PhD, the author of the rat study published in Science late
Mundy, professor of medicine at the University of Texas Health Science
Center San Antonio, tells WebMD that he is "tremendously pleased with all
these studies. Firstly, because they suggest that statins are effective in
humans and secondly, they show that they may be effective at [the normal
Since publishing his animal work, Mundy says he had been pursuing the
concept of a "bone statin", which would be delivered by a skin patch.
The skin patch could potentially keep more of the drug working in the body
because it would avoid breakdown by the stomach and intestines. But these
recent studies suggest the skin patch may not be needed to protect against
fractures because the oral form seems to work for fracture prevention.
Mundy says he is especially encouraged by the JAMA paper from
Christoph R. Meier, MD, PhD, of the University Hospital of Basel Switzerland,
because that study suggests that statins may begin to make a difference quickly
-- in a few weeks to a few months.
Meier's group studied nearly 4,000 fracture patients aged 50 to 89 and
compared their statin use to patients of the same age range and gender with no
fractures. They found that current statin use reduced fracture risk by 45%,
while recent statin use reduced the risk by 33%, and any history of statin use
reduced risk by 13%.
In the second JAMA paper, Philip S. Wang MD, DrPH, of Brigham and
Women's Hospital in Boston, studied data collected from New Jersey residents
aged 65 or older who were enrolled in Medicare, Medicaid, or the Pharmacy
Assistance for the Aged and Disabled program. They identified 1,222 patients
who had hip fractures in 1994 and compared their statin use to 4,888 healthy
"We found that statin use for 180 days prior was associated with a 50%
reduction in hip fracture risk, and use of statins in the prior three years was
associated with a 43% decrease in risk," Wang tells WebMD.
Cummings says that although the data from this cluster of studies is very
encouraging, there are factors that need to be considered For example, when
drugs seem to work quickly, it may be because the people taking them were at
low risk to begin with, he says. "But on the other hand, people who adhere
to medications over the long haul are the ones who tend to have the best
prognosis and best health status," he says.
Wang says that since published data from statin studies for cholesterol
control suggest that "each statin has a slightly different effect on
[cholesterol], it is possible that each would also work differently on