Mixed results for bone effects of statins
Observational studies suggest that women taking statins to treat hyperlipidaemia have a lower risk of hip and non-spine fractures, but post hoc analyses of cardiovascular trials do not, say researchers.
They analysed statin use and fracture rate among older women in four
prospective studies and performed a cumulative meta-analysis of published
and unpublished observational studies and clinical trials.
They found that statin users in the four prospective studies had fewer
hip fractures (relative hazards 0.19–0.62) and non-spine fractures
(0.49–0.95) than non-users. The meta-analysis of observational
studies was consistent with these findings but meta-analysis of clinical
trials did not support a protective effect of statins for hip or non-spine
fractures. The authors note potential explanations such as the fact that
statin trial participants are likely to be more compliant than statin
users in observational studies.
They report a relatively small effect of statins on bone mineral density
which they say is insufficient to account for the observed reductions
in fractures, and suggest that mechanisms such as an alteration of bone
turnover or beneficial effects on bone microarchitecture or geometry
may be responsible (Archives of Internal Medicine 2004;164:146). |
The
Pharmaceutical Journal