Therapeutics & Drug Brief: Use of Statins and Risk of Fractures
Therapeutics & Drug Brief
Use of Statins and Risk of Fractures
Source: van Staa TP, et al. JAMA. 2001;285:1850-1855.
Geranylgeranylpyrophosphate (GGPP) is a protein that exerts control over osteoclast-mediated bone resorption. Statins (ie, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) block production of mevalonic acid, a precursor of GGPP. It has been suggested that currently used osteoporosis treatments like bisphosphonates may have an effect upon bone resorption through GGPP suppression in this same pathway. Recent epidemiologic data have suggested that statins may reduce fracture risk.
van Staa and colleagues studied a large population (n = 81,880) of cases from general practices in the United Kingdom of persons who had sustained a fracture (vertebra, clavicle, humerus, radius, ulna, carpal bone, hip, ankle, or foot), and compared this information with an equal body of age and sex-matched controls. Odds ratios were determined for use of statins vs. non-use of statins and likelihood of fracture.
Regardless of statin dose studied, no difference in odds ratio of fracture between current statin users and non users was discerned. This lack of effect was unaltered by duration of use of statin dose. van Staa et al suggest that the previously reported observational reports of statin-associated reduced fracture rates may have been due to the confounding effects of obesity in these patients.
The Therapeutics & Drug Brief was written by Louis Kuritzky, MD.
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