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Statin Drugs and the Risk of Fracture—Reply

Christoph R. Meier, PhD, MSc; Raymond G. Schlienger, PhD; Marius E. Kraenzlin, MD; Brigitta Schlegel, MD; Hershel Jick, MD
JAMA. 2000;284(15):1921-1922. doi:10.1001/jama.284.15.1921.
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In Reply: Dr El-Sohemy comments on recent findings that pravastatin does not stimulate bone formulation in vitro by increasing BMP-2. This mechanism is a current focus of interest in the search of a possible pharmacologic explanation for the observed effect of statins on bone, but it is not yet proven.

We stratified statin users and assessed the risk of having a fracture in association with current exposure to simvastatin or pravastatin, the 2 statins most often used in our study sample. Compared with nonusers of any lipid-lowering drugs, ORs for current use of simvastatin (90 patients and 671 controls) and pravastatin (10 patients and 131 controls) were 0.61 (95% confidence interval [CI], 0.47-0.79) and 0.34 (95% CI, 0.17-0.65), respectively. There was insufficient cholestyramine use in our sample to perform a separate analysis of its effect on fractures.

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