Statins may reduce femoral osteolysis in patients with total Hip arthroplasty

Lübbeke, Anne; Garavaglia, Guido; Rothman, Kenneth J.; Bonvin, Alexis; Roussos, Constantinos; Miozzari, Hermès Howard; Hoffmeyer, Pierre

doi:10.1002/jor.22262

Cited by 15 publications

(15 citation statements)

References 29 publications

(34 reference statements)

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“…Obesity has been deemed a relative contraindication for hip replacement and a risk factor for complications and prosthesis failure . Although obesity was shown to increase the risk of early revision due to aseptic loosening and/or osteolysis by almost fivefold, statins were suggested to reduce femoral osteolysis in hip arthroplasty . However, some studies revealed obesity paradox, in which obesity or its correlates provided some protective effect in hip replacement .…”

Section: Discussionmentioning

confidence: 99%

“…34 Although obesity was shown to increase the risk of early revision due to aseptic loosening and/or osteolysis by almost fivefold, 35 statins were suggested to reduce femoral osteolysis in hip arthroplasty. 36 However, some studies revealed obesity paradox, in which obesity or its correlates provided some protective effect in hip replacement. 37 Further, the risk of femoral osteolysis in some normal-weight patients was higher compared with overweight patients.…”

Section: In Silico Research On Periprosthetic Osteolysismentioning

confidence: 99%

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Development of an Integrated Platform Using Multidisciplinary Real‐World Data to Facilitate Biomarker Discovery for Medical Products

Dabic

Azarbaijani

Karapetyan

et al. 2019

Clinical Translational Sci

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Translational multidisciplinary research is important for the Center for Devices and Radiological Health's efforts for utilizing real‐world data (RWD) to enhance predictive evaluation of medical device performance in patient subpopulations. As part of our efforts for developing new RWD‐based evidentiary approaches, including in silico discovery of device‐related risk predictors and biomarkers, this study aims to characterize the sex/race‐related trends in hip replacement outcomes and identify corresponding candidate single nucleotide polymorphisms (SNPs). Adverse outcomes were assessed by deriving RWD from a retrospective analysis of hip replacement hospital discharge data from the National Inpatient Sample (NIS). Candidate SNPs were explored using pre‐existing data from the Personalized Medicine Research Project (PMRP). High‐Performance Integrated Virtual Environment was used for analyzing and visualizing putative associations between SNPs and adverse outcomes. Ingenuity Pathway Analysis (IPA) was used for exploring plausibility of the sex‐related candidate SNPs and characterizing gene networks associated with the variants of interest. The NIS‐based epidemiologic evidence showed that periprosthetic osteolysis (PO) was most prevalent among white men. The PMRP‐based genetic evidence associated the PO‐related male predominance with rs7121 (odds ratio = 4.89; 95% confidence interval = 1.41−17.05) and other candidate SNPs. SNP‐based IPA analysis of the expected gene expression alterations and corresponding signaling pathways suggested possible role of sex‐related metabolic factors in development of PO, which was substantiated by ad hoc epidemiologic analysis identifying the sex‐related differences in metabolic comorbidities in men vs. women with hip replacement‐related PO. Thus, our in silico study illustrates RWD‐based evidentiary approaches that may facilitate cost/time‐efficient discovery of biomarkers for informing use of medical products.

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Section: Discussionmentioning

confidence: 99%

Section: In Silico Research On Periprosthetic Osteolysismentioning

confidence: 99%

Development of an Integrated Platform Using Multidisciplinary Real‐World Data to Facilitate Biomarker Discovery for Medical Products

Dabic

Azarbaijani

Karapetyan

et al. 2019

Clinical Translational Sci

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“…The relative risk ratio after adjustment for confounders (age, sex, activity level, BMI, diagnosis, bearing surface, type of stem) was 0.38 (95% CI 0.15; 0.99). This analysis did not have sufficient follow-up length to determine whether the risk of revision was lower in the statin ever-use group 49 .…”

Section: There Is An Established Research Base For a Class Of Drug Knmentioning

confidence: 99%

Statins, Bone Biology and Revision Arthroplasty: Review of Clinical and Experimental Evidence

Sorial

Anjum

Cook

et al. 2020

Preprint

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Osteoarthritis is a painful, disabling condition which is increasing in prevalence as a result of an ageing population. With no recognised disease limiting therapeutics, arthroplasty of the hip and knee is the most common and effective treatment for lower limb osteoarthritis, however lower limb arthroplasty has a finite life-span and a proportion of patients will require revision arthroplasty. With increasing life expectancy and the proportion of younger (<65 years) patients undergoing arthroplasty, the demand for revision arthroplasty after implant failure is also set to increase. Statins are cholesterol modulating drugs widely used for cardiovascular risk reduction, which have been noted to have pleiotropic effects including potentially influencing arthroplasty survival. Epidemiological and experimental research have demonstrated that there may be a biological and population-wide effect of statins in reducing the risk of revision arthroplasty. This work summarises the current breadth of evidence for this phenomenon including in vitro, in vivo and epidemiological research.

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“…The discordance between observational studies and randomized trials is explained by selection bias, confounding by indication, or a “healthy user” phenomenon 117 . Systemically administered statins are associated with a reduced risk of aseptic revision and osteolysis in at least two THA studies 118,119 . Yet, evidence from local delivery of statins on orthopedic implants is so far inconclusive.…”

Section: Medicationsmentioning

confidence: 99%

Clinical Factors, Disease Parameters, and Molecular Therapies Affecting Osseointegration of Orthopedic Implants

et al. 2016

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Total hip and knee arthroplasty are effective interventions for management of end-stage arthritis. Indeed, about 7 million Americans are currently living with artificial hip and knee joints. The majority of these individuals, however, will outlive their implants and require revision surgeries, mostly due to poor implant osseointegration and aseptic loosening. Revisions are potentially avoidable with better management of patient-related risk factors that affect the osseointegration of orthopedic implants. In this review, we summarize the published clinical literature on the role of demographics, biologic factors, comorbidities, medications and aseptic loosening risk. We focus on several systemic and local factors that are particularly relevant to implant osseointegration. Examples include physiological and molecular processes that are linked to hyperglycemia, oxidative stress, metabolic syndrome and dyslipidemia. We discuss how orthopedic implant osseointegration can be affected by a number of molecular therapies that are antiresorptive or bone anabolic (i.e. calcium, vitamin D, bisphosphonates, calcitonin, strontium, hormone replacement therapy, selective estrogen-receptor modulators).

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Statins may reduce femoral osteolysis in patients with total Hip arthroplasty

Cited by 15 publications

References 29 publications

Development of an Integrated Platform Using Multidisciplinary Real‐World Data to Facilitate Biomarker Discovery for Medical Products

Development of an Integrated Platform Using Multidisciplinary Real‐World Data to Facilitate Biomarker Discovery for Medical Products

Statins, Bone Biology and Revision Arthroplasty: Review of Clinical and Experimental Evidence

Clinical Factors, Disease Parameters, and Molecular Therapies Affecting Osseointegration of Orthopedic Implants

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