UCSF research featured at international meeting on bone and calcified tissue

An analysis of eight recent observational studies suggests a reduction in hip and non-spine fractures among individuals taking statins, medicines commonly prescribed for the treatment of elevated cholesterol levels, researchers at the University of California, San Francisco reported today.

Douglas C. Bauer, MD, UCSF professor of medicine, epidemiology and biostatistics, presented his research on "Statin Use and Fracture" at the 1st joint meeting of the International Bone and Mineral Society and the European Calcified Tissue Society in Madrid, Spain on June 10.

UCSF researchers performed extensive literature searches to determine the relationship between statin use and hip and non-spine fracture risk, and then combined the results of those studies using a technique called meta-analysis. "A meta-analysis of the studies support a protective effect of statins on hip and other types of fractures, although additional controlled trials of these agents among those at high risk of fracture are needed," Bauer said.

The analysis included eight observational studies in which some men and women used statins, or HMG-CoA reductase inhibitors. More than 200,000 subjects were studied, with statin users numbering more than 12,000 and the numbers of fractures totaling about 10,000. Hip fractures were reduced by nearly 60 percent among the individuals taking statins. In summary, the analysis supports previous observations in animals that statins may be useful agents for osteoporosis, but additional studies are needed to confirm this beneficial effect. Bauer said.

Bauer has been working on bone research for 11 years at UCSF and said that this study is noteworthy and demonstrates that medications may have unexpected beneficial effects. In particular, this research opens the possibility of developing a new class of therapeutic agents for osteoporosis.

Bauer and his colleagues demonstrated that statins (a drug class currently used in the prevention of cardiovascular diseases because of their blood lipid lowering properties) also can exert a protective effect on osteoporotic fractures. In related studies, other researchers hope to demonstrate that the unexpected effect of statins on bone could be the result of an enhanced production of a growth factor (BMP2) that stimulates bone formation.

Meeting presentations on the prevention and treatment of osteoporosis also will discuss combinations of estrogen, an inhibitor of bone resorption, and parathyroid hormone, a stimulator of bone formation, that produce a dramatic bone density increase in postmenopausal osteoporosis.

More than 2,000 doctors and scientists will gather at the Madrid meeting June 5-10 to share information about the prevention and management of bone disease. With an aging worldwide population, bone and joint disease are among the major health threats. Education, prevention, diagnosis and treatments of bone diseases are becoming increasingly important.

In 1999, osteoporosis affected more than 35 million people in U.S., France, Germany, Italy, Spain, the United Kingdom and Japan, and now is considered by the World Health Organization to be second only to cardiovascular disease as a leading health care concern.

Several common malignant tumors (breast or prostate cancer and blood cancers such as multiple myeloma) have been found to have a predilection to invade the skeleton. This bone invasion is a catastrophic complication, causing severe pain, fracture after trivial injury and nerve compression. The prevention of the occurrence and development of bone metastases is a major challenge in cancer therapy.

For the first time, research at the meeting will be presented to show the effects of several new potential drugs and/or therapeutic regimens in the prevention and treatment of osteoporosis and other bone diseases including skeletal lesions induced by certain cancers.

Bauer's colleagues on the statin study include Dennis Black, PhD, UCSF adjunct professor of epidemiology and biostatistics and Marjolien van der Klift, MD, professor at Erasmus University, Rotterdaam, Netherlands.

For more information or to contact Bauer and his colleagues, please call Twink Stern at 415-476-2557.