With the development of new bisphosphonates such as zoledronate and ibandronate, the focus of bone research has been on the osteoclasts, the bone resorbing or destroying cells in myeloma. Block the osteoclast more effectively and you can have fewer bone problems or skeletal related events (SREs). But a critical problem remains: bone healing. Osteoblasts must be active to heal bones and, for some reason, osteoblasts shut down in myeloma patients.
How to get osteoblasts active again is an issue highlighted in a recent study by IMF Board member and Scientific Advisor Prof. Gregory R. Mundy. In animal studies, Prof. Mundy showed that cholesterol lowering statins (drugs such as Lipitor®, Zocor®, Mevacor®) can stimulate osteoblasts and bone healing. Might statins help bone healing in myeloma patients? Two studies, published in rapid succession in Lancet and JAMA, indicated fewer bone problems (particularly reduction in the number of fractures) in post-menopausal women taking statins. Another study in the Archives of Internal Medicine indicated that long term statin use appears to be safe despite potential toxicities. The development of cancer, for example, was less likely in statin users.
Would prior statin use result in fewer SREs at diagnosis? There were no data on the use of statins in myeloma patients. Prof. Mundy, along with Prof. Dr. Brian G.M. Durie and Dr. Steven R. Cummings decided to evaluate bone disease at diagnosis in myeloma patients who had been taking statins to lower their cholesterol levels. Since only 6-7% of myeloma patients have had high cholesterol sufficient to require statin therapy, it has taken time to gather information on statin use. Final results will be published and the statistics will be made available at the IMF website as well as in the next issue of Myeloma Today.