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Osteoporos Int (2017) 28:2739–2740 DOI 10.1007/s00198-017-4069-1 LETTER Statin use does not protect from fractures: the healthy adherer effect is a plausible explanation in observational studies 1 2 3 A. Donzelli & A. Battaggia & A. Schivalocchi Received: 13 January 2017 /Accepted: 26 April 2017 /Published online: 29 May 2017 The Author(s) 2017. This article is an open access publication Dear Editor, adherence to drug therapy may be a surrogate marker for a The conclusions of the recently published meta-analysis by general healthier behavior. An et al. [1], including 23 observational studies and 10 ran- Famous RCTs showed better outcomes in groups with a domized controlled trials (RCTs), are as follows: Bstatin treat- good adherence to placebo, e.g., in WHI [3], comparing hor- monal replacement therapy versus placebo in postmenopausal ment may be associated with a decreased risk of overall and hip fractures, an increased BMD at the total hip, at the lumbar women, high-adherers in the placebo arm showed significant spine, and OC.^ favorable outcomes, including fewer hip fractures (HR 0.50; We disagree with these conclusions, for the following 95% CI 0.33–0.78) and a decrease in mortality (HR 0.64; reasons. 0.51–0.80) [3], after adjusting for potential confounders. First, observational
Osteoporosis International – Springer Journals
Published: May 29, 2017
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