Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2006; all rights reserved.
Commentary |
Commentary: Statins and fracture risk—unresolved questions
Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Hebelstrasse 2, 4031 Basel, Switzerland. E-mail: meierch@uhbs.ch
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In 2000, we found a substantially reduced fracture risk for patients who used hydroxymethyl-glutaryl coenzyme A reductase inhibitors, a class of lipid-lowering drugs also called ‘statins’1 in a retrospective nested case–control analysis using data from the British General Practice Research Database (GPRD). Two large US-based epidemiological analyses reported virtually the same findings.2,3 These studies were stimulated by an intriguing paper by Mundy et al. who screened numerous pharmacological compounds in an animal model. They found a marked increase in bone mass in simvastatin-treated rodents.4 A recent review article by Bauer5 nicely summarized these as well as numerous subsequent observational studies: most of them consistently found a reduced fracture risk