Osteoporosis Gets Surprise Helper

Friday, June 23rd 2000, 12:00 am
By: News On 6

LONDON (AP) — A cholesterol-lowering drug taken by millions to prevent heart attacks might also protect women from having osteoporosis-linked bone fractures, offering a safe alternative to hormone replacement therapy.

New research, published this week in The Lancet medical journal, shows that women over 60 who took the statin cholesterol drugs for at least a year had half the risk of breaking bones.

Hormone replacement therapy, taken by post-menopausal women partly to head off osteoporosis, has also been shown to reduce cholesterol levels. But it also increases the risk of breast cancer.

Statins — marketed in the United States as Mevacor, Zocor, Lipitor, Lescol and Pravachol — have been around for years and have a long safety record. They can sometimes cause reversible minor injury to the liver or, rarely, muscle inflammation.

While current osteoporosis drugs slow bone erosion, previous studies investigating statins have indicated they might restore bone lost to the disease.

``This is a big step and an important step,'' said Douglas Bauer, a professor of medicine, epidemiology and biostatistics at the University of California in San Francisco, who was not connected with the study. ``It basically confirms highly suggestive evidence found in the lab. It's encouraging enough to prompt large studies to see if statins really prevent fractures.''

``Three to five years from now, we could well be prescribing women statins instead of estrogens,'' said Bauer, who has done similar research. ``This could really be applicable to a huge number of women.''

Osteoporosis, also known as brittle-bone disease, affects about one in three women and about one in 10 men. It gradually weakens bones and often leads to painful and crippling fractures.

Twenty percent of those who suffer hip fractures die within a year because of complications and many more never return to independent living.

About half of women over 50 have a fracture because of osteoporosis sometime during their lives.

In the study by scientists at Brigham and Women's Hospital in Boston, 928 women over 60 who had suffered a bone fracture linked to osteoporosis between October 1996 and September 1997 were matched with a total of 2,747 women of the same age from the same health maintenance organizations who had not fractured a bone.

The researchers examined all the women's health insurance claims and pharmacy dispensing records for the year the fractures occurred and the two previous years to see who had been taking statins and for how long. They also tracked who had been taking cholesterol drugs other than statins.

They found that compared with women who had no record of statin prescriptions during the previous two years, those who had been on the drugs for at least a year were half as likely to fracture a bone.

People with cholesterol problems are also often overweight. Body fat protects bones by cushioning a fall and by making the bones stronger because the skeleton has to support the extra weight.

But it's unlikely that the women taking statins were protected from fractures because of any extra weight, said Dr. K. Arnold Chan, a drug epidemiologist at Brigham and Women's who led the study.

``Although we cannot be sure that body weight is the explanation, we mostly ruled that out,'' Chan said. ``We would have expected to see a similar effect for the non-statin drugs, and we didn't.''

The statin drugs used in the study are sold generically as lovastatin, simvastatin, atorvastatin, fluvastatin and pravastatin. The research was not paid for by any of the drug companies that market the drugs worldwide.