Association between statin use and osteoporotic fracture in patients with chronic obstructive pulmonary disease: a population-based, matched case-control study

Abstract

Background In the recent years, chronic obstructive pulmonary disease (COPD) has been found to be associated with a higher risk of new-onset osteoporotic fracture (NOF). However, the existence of such an association in the COPD patients receiving statin treatment remains unknown. The present study aimed to investigate the association between COPD and NOF in statin-treated patients. Methods The present study was conducted over a period of 10 years (January 2004 to December 2013) in Taiwan. COPD patients receiving statin treatment were included in the statin user group, whereas the randomly selected statin non-users, with 1:1 matching for sex, age, index date, and Charlson Comorbidity Index, were included in the statin non-user group. The hazard ratio (HR) of NOFs in COPD patients was estimated between statin user and non-user groups. Results A total of 86,188 cases were identified as the statin-treated patients, and 86,188 subjects were included in the control group of statin non-users. Initially, the risk of NOF was found to be higher among the statin users as compared to non-users [HR, 1.12; 95% confidence interval (CI), 1.01–1.25]. However, the calculation of risk for NOFs after the adjustment for age, sex, comorbidities, and concurrent medications indicated no association of NOF (HR, 0.81; 95% CI, 0.55–1.21) with COPD in patients receiving statin treatment as compared to statin non-users. Conclusion The results of the study provided first evidence for the absence of any association between COPD and NOFs in statin-treated patients during a follow-up period of 10 years. Thus, the findings of this study might support the hypothesis stating the potent pleiotropic effects of statins. In clinical practice, these drugs might prove beneficial for the patients with COPD.

Association between osteoporotic fractures and statin use – A review of literature and results of a preliminary case control study done at National Hospital of Sri Lanka

“…The most recently published population-based study we could find was also done in Taiwan by Chen et al among patients with COPD. They demonstrated a beneficial effect of statins in patients with COPD against the occurrence of NOF fractures at 10 years follow up [39]. Clinical studies done in south asian cohorts in this regard have been lacking so far and we were not able to find any studies done in Sri lanka.…”

Association between Osteoporosis and Previous Statin Use: A Nested Case-Control Study

“…A nationwide retrospective population-based cohort study in Taiwan described a 48% decreased risk of new-onset osteoporosis in statin users compared to nonstatin users (adjusted hazard ratio = 0.52, 95% CI = 0.50-0.54) [24]. Another population-based cohort study in Taiwan demonstrated no association of new-onset osteoporotic fracture with statin use [25]. On the contrary, a cross-sectional retrospective study in Austria reported an increased rate of osteoporosis related to statin use in the overall study population (aOR = 3.62, 95% CI = 3.55-3.69) [17].…”