A Comprehensive Review of the Pharmacology of Statins and its Clinical Implications
Athiban Inbarajan 1*, Giri GVV 2, Anusha D 3, Alan Mathew Punnoose 4, Jasline David J 5, Mubeena S 6
Journal of Angiotherapy 8(4) 1-8 https://doi.org/10.25163/angiotherapy.849617
Submitted: 26 February 2024 Revised: 01 April 2024 Published: 01 April 2024
Abstract
Statins are commonly prescribed medications used to lower cholesterol levels and reduce the risk of heart attacks. Recent data suggest that statins also play a role in regulating bone metabolism by stimulating the formation of new bone tissue, both in laboratory studies (in vitro) and in living organisms (in vivo). Among statins, simvastatin has emerged as particularly effective in promoting the activity of bone morphogenetic protein-2 (BMP-2), a key factor in the differentiation of osteoblasts, the cells responsible for bone formation. Furthermore, simvastatin inhibits the production of mevalonate and isoprenoids, compounds crucial for the formation of osteoclasts, the cells involved in bone resorption. This dual action of simvastatin, promoting bone formation while inhibiting bone resorption, suggests its potential as a therapeutic agent for bone regeneration, particularly in the context of dental implants and the treatment of osteoporosis. The aim of this article is to review existing literature on the effects of simvastatin, with a primary focus on its role in promoting BMP-2 activity and its effects on bone formation, especially in patients with diabetes mellitus undergoing dental implantation. An electronic search of the MEDLINE-PubMed database was conducted up to December 2008 to identify relevant in vitro studies investigating the effects of statins on BMP-2 production, as well as in vivo studies evaluating the effects of statins on bone formation and preservation. The majority of reviewed investigations focused on simvastatin as the representative statin agent. These studies generally supported the hypothesis that simvastatin possesses osteoinductive properties mediated through BMP-2 and exerts osteoprotective effects by inhibiting osteoclast activation. Overall, simvastatin shows promise as a potential therapeutic agent for inhibiting and treating bone resorption, offering potential benefits for patients requiring bone regeneration procedures such as dental implantation.
Keywords: Antiresorptive drugs, Bone regeneration, Dental Implants, Diabetes, Osseointegration, Simvastatin
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