We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Statins and Fracture Risk

Christoph R. Meier, PhD, MSc; Raymond G. Schlienger, PhD; Marius E. Kraenzlin, MD; Brigitta Schlegel, MD; Hershel Jick, MD
JAMA. 2001;286(6):669-670. doi:10.1001/jama.286.6.669.
Text Size: A A A
Published online


To the Editor: Dr van Staa and colleagues1 concluded that "use of statins . . . was not associated with a reduction in risk of fracture." This conclusion is contrary to the results of our study2 as well as others.3,4 Our results, like those of van Staa et al, were derived from the General Practice Research Database (GPRD). However, the study by van Staa et al encompassed 683 practices originally considered to have data of satisfactory quality; by contrast, the Boston Collaborative Drug Surveillance Program conducts ongoing internal (unpublished) validation studies to identify practices that provide unsatisfactory data. As a result, several practices were excluded and our recent study encompassed only 340 practices. Van Staa et al also failed to exclude patients at high risk for fracture, for instance patients with osteoporosis, osteomalacia, cancer, alcoholism, and those receiving bisphosphonates. We excluded such patients since it is well recognized that including persons who are already at high risk for an outcome will dilute the effect of a drug on the outcome.5 These methodological differences resulted in van Staa et al identifying 81 880 fracture cases, while we identified only 3940.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.