Statins, bone metabolism and treatment of bone catabolic diseases.

The discovery that statins had bone anabolic properties initiated many investigations into their use for treatment of bone catabolic diseases, such as osteoporosis. This paper reviews the molecular basis of statin's role in bone metabolism, and animal and human studies on the impact of systemic statins on osteoporosis-induced bone fracture incidence and healing, and on bone density. Limitations of systemic statins are described along with alternative dosing strategies, including local applications and bone-targeting systemic preparations. The principal findings of this review are: (1) traditional oral dosing with statins results in minimal efficacy in the treatment of osteoporosis; (2) local applications of statins show promise in the treatment of accessible bony defects, such as periodontitis; and (3) systemically administered statins which can target bone or inflammation near bone may be the safest and most effective strategy in the treatment of osseous deficiencies.