More Evidence Cholesterol Drugs Reduce Fracture Risk
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," Cummings says.
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 solution."
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 last year.
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 cholesterol-lowering doses]."
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.