Potential use of HMG-CoA reductase inhibitors for osteoporosis

OBJECTIVE: To review the current clinical data describing the effects of hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors in bone formation and reduction of fracture incidence and their potential use for osteoporosis. DATA SOURCES: English-language articles and abstracts were identified from a MEDLINE database search (1966-May 2001) that used the key words osteoporosis, HMG-CoA reductase inhibitors, and treatment. STUDY SELECTION AND DATA EXTRACTION: All the articles identified from the data sources were evaluated, and all information deemed relevant was included in this review. DATA SYNTHESIS: In the past, there has been considerable emphasis placed in the detection, prevention, and treatment of osteoporosis. New drug therapies have been introduced in the market aimed at decreasing bone loss and increasing bone formation, with the ultimate goal of decreasing fractures. Currently, there are a variety of agents available for the treatment of osteoporosis. A limited number of case-control studies have suggested that HMG-CoA reductase inhibitors (statins) may have the potential to reduce the risk of fractures by increasing bone formation, although other studies have failed to show a benefit in fracture reduction. The potential benefit of this therapy is still undetermined because of a lack of randomized, controlled, clinical trials and conflicting data. CONCLUSIONS: At this time, there are limited data on the role of statins in the treatment of osteoporosis. Practitioners must be cautious when using these agents over other proven conventional therapies. Randomized, controlled, clinical trials are needed to accurately determine the role of these agents in the treatment of osteoporosis.

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