Statins for Adult Osteoporosis: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 DENG Juelin , YANG Ming , YUE Jirong

Department of Geriatrics , West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

DENG Juelin, Email: juelind2005@yahoo.com.cn

Keywords：

Statins; Osteoporosis; Randomized controlled trial; Systematic review

DOI：

10.7507/1672-2531.20080059

Video：

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Objectives　 To assess the efficacy and safety of statins for adult osteoporosis.
Methods　 We electronically searched The Cochrane Library (Issue 4, 2007), MEDLINE (1990 to November 2007), EMBASE (1990 to November 2007), Current Controlled Trials, The National Research Register, CBM (1990 to November 2007), VIP (1990 to November 2007) and CNKI (1990 to November 2007). We also handsearched some related journals and identified randomized controlled trials of statins versus placebo in adults with osteoporosis.
Results　 Two randomized controlled trials were included. We didn’t perform meta-analysis due to heterogeneity. No significant differences were observed in the changes of bone density at the lumbar spine and total hip from baseline between statins and placebo. However, a significant increase in bone density was found in response to simvastatin at the forearm. Biochemical markers of bone metabolism changes from baseline did not differ significantly between statins and placebo groups.
Conclusions　 The evidence currently available does not support the use of statins in the treatment of osteoporosis. Further randomized, double-blind, placebo-controlled trials are needed in order to define the efficacy and acceptability of statins in the treatment of osteoporosis.

Citation： DENG Juelin,YANG Ming,YUE Jirong. Statins for Adult Osteoporosis: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2008, 08(4): 284-287. doi: 10.7507/1672-2531.20080059 Copy

1.	Hanley DA, Josse RG. Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada: Introduction. CMAJ, 1996, (155): 921-923.
2.	姚朗, 苏勇, 蒋华良. 他汀类调血脂药物的潜在新作用-抗骨质疏松. 中国新药与临床杂志, 2002, 21(4): 249-251.
3.	Hatzigeorgiou C, Jackson JL. Hydroxymethylglutaryl-coenzyme A reductase inhibitors and osteoporosis: a meta-analysis. Osteoporos Int, 2005, 16(8): 990-998.
4.	Uzzan B, Cohen R, Nicolas P, et al. Effects of statins on bone mineral density: a meta-analysis of clinical studies. Bone, 2007, 40(6): 1581-1587.
5.	Juni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001, 323(7303): 42-46.
6.	Bone HG, Kiel DP, Lindsay RS, et al. Effects of atorvastatin on bone in postmenopausal women with dyslipidemia: a double-blind, placebo-controlled, dose-ranging trial. J Clin Endocrinol Metab, 2007, 92(12): 4671-4677.
7.	Rejnmark L, Buus NH, Vestergaard P, et al. Effects of simvastatin on bone turnover and BMD: a 1-year randomized controlled trial in postmenopausal osteopenic women. J Bone Miner Res, 2004, 19(5): 737-744.
8.	Mundy G, Greet R, Harris S, et al. Stimulation of bone formation in vitro and in rodents by statins. Science, 1999, 286(3): 1946-1949.
9.	Bjarnason NH, Riis BJ, Christiansen C. The effect of fluvastatin on parameters of bone remodeling. Osteoporos Int, 2001, 12(5): 380-384.
10.	Reid IR, Hague W, Emberson J, et al. Effect of pravastatin on frequency of fracture in the LIPID study: secondary analysis of a randomised controlled trial. Long-term Intervention with Pravastatin in Ischaemic Disease. Lancet, 2001, 357(9255): 509-512.
11.	Wishart J, Horowitz M, Need A, et al. Relationship between forearm and vertebral mineral density in postmenopausal women with primary hyperparathyroidism. Arch Intern Med, 1990, 150(6): 1329-1331.
12.	Steven R, Douglas C. Do statins prevent both cardiovascular disease and fracture? JAMA, 2000, 283(24): 3255-3257.

1. Hanley DA, Josse RG. Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada: Introduction. CMAJ, 1996, (155): 921-923.
2. 姚朗, 苏勇, 蒋华良. 他汀类调血脂药物的潜在新作用-抗骨质疏松. 中国新药与临床杂志, 2002, 21(4): 249-251.
3. Hatzigeorgiou C, Jackson JL. Hydroxymethylglutaryl-coenzyme A reductase inhibitors and osteoporosis: a meta-analysis. Osteoporos Int, 2005, 16(8): 990-998.
4. Uzzan B, Cohen R, Nicolas P, et al. Effects of statins on bone mineral density: a meta-analysis of clinical studies. Bone, 2007, 40(6): 1581-1587.
5. Juni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001, 323(7303): 42-46.
6. Bone HG, Kiel DP, Lindsay RS, et al. Effects of atorvastatin on bone in postmenopausal women with dyslipidemia: a double-blind, placebo-controlled, dose-ranging trial. J Clin Endocrinol Metab, 2007, 92(12): 4671-4677.
7. Rejnmark L, Buus NH, Vestergaard P, et al. Effects of simvastatin on bone turnover and BMD: a 1-year randomized controlled trial in postmenopausal osteopenic women. J Bone Miner Res, 2004, 19(5): 737-744.
8. Mundy G, Greet R, Harris S, et al. Stimulation of bone formation in vitro and in rodents by statins. Science, 1999, 286(3): 1946-1949.
9. Bjarnason NH, Riis BJ, Christiansen C. The effect of fluvastatin on parameters of bone remodeling. Osteoporos Int, 2001, 12(5): 380-384.
10. Reid IR, Hague W, Emberson J, et al. Effect of pravastatin on frequency of fracture in the LIPID study: secondary analysis of a randomised controlled trial. Long-term Intervention with Pravastatin in Ischaemic Disease. Lancet, 2001, 357(9255): 509-512.
11. Wishart J, Horowitz M, Need A, et al. Relationship between forearm and vertebral mineral density in postmenopausal women with primary hyperparathyroidism. Arch Intern Med, 1990, 150(6): 1329-1331.
12. Steven R, Douglas C. Do statins prevent both cardiovascular disease and fracture? JAMA, 2000, 283(24): 3255-3257.

Chinese Journal of Evidence-Based Medicine

Statins for Adult Osteoporosis: A Systematic Review

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