12 November 2018

Women with osteoporosis commonly have other co-morbidities and are often on medications that may impact on bone health. Whilst considerable focus has been directed toward treatments with deleterious effects on bone, other non-osteoporosis medications may have favorable effects on bone turnover. This study in over 45,000 users of statins, compared to over 115,000 controls, included over 68,000 women, with an age range of 50–90 years [2]. Follow-up occurred over a 13-year period. 10% of the cohort overall developed osteoporosis: 6.8% of statin users and 11.3% of non-users, with a hazard ratio of developing osteoporosis in statin users of 0.52 (95% CI 0.49–0.54). When the individual statin products were examined, simvastatin, atorvastatin and rosuvastatin were all associated with a lower risk of developing osteoporosis (HR 0.85, 95% CI 0.76–0.94; HR 0.68, 95% CI 0.63–0.74; HR 0.43, 95% CI 0.36–0.52, respectively). No reduction in risk was seen for pravastatin, however: HR 0.89 (95% CI 0.76–1.05).

Comment

The authors highlighted the facts that statins augment osteoblast activity and inhibit osteoblast apoptosis and increase bone formation, in addition to sharing the same pathway as nitrogen-containing bisphosphonates. Furthermore, it has been reported that simvastatin has been shown to inhibit RANKL-induced osteoclast differentiation.

Sonia Davison

Endocrinologist, Women’s Health Research Program, Monash University, Australia

Reference

Lin TK, Chou P, Lin CH, Hung YJ, Jong GP. Long-term effect of statins on the risk of new-onset osteoporosis: A nationwide population-based cohort study. PLoS One 2018;13:e0196713
https://www.ncbi.nlm.nih.gov/pubmed/29723231