Statin Therapy Could Significantly Benefit COPD Patients

A new study claims that statin treatment in patients with chronic obstructive pulmonary disease (COPD) could have a beneficial effect on several clinically relevant adverse outcomes, including future exacerbations and death.

Researchers at Liverpool Hospital (Sydney, NSW, Australia) and the Woolcock Institute of Medical Research (Sydney, NSW, Australia) conducted a systematic review of nine original studies published between 2006 and 2008 that specifically analyzed the effects of statin treatment on COPD. One study was a randomized controlled trial, one was a retrospective nested case-control study, five were retrospective cohort studies (of which one was linked with a case-control study), and one was a retrospective population-based analysis. The researchers found that based on the data analyzed, statin therapy for COPD was associated with decreased all-cause mortality in three out of four studies, and decreased COPD-related mortality. Statin therapy was also associated with a reduced incidence of respiratory-related urgent care, COPD exacerbations, and need for intubation; statins also attenuated decline of pulmonary function. The one randomized controlled trial investigated the effects of pravastatin 40 mg/day compared to placebo over a six-month period in 125 clinically stable COPD patients. In this trial, it was reported that statin users experienced significant improvements in exercise capacity and dyspnea, in association with decreased levels of the inflammatory markers, C-reactive protein, and interleukin-6, but no improvement in lung function.

The researchers noted that it is not clear from existing data what types of statins, dosage, and length of treatment are needed to exhibit a pleiotropic effect; they also pointed out that because most of the available data are based on observational studies, randomized controlled trials are urgently needed to evaluate the therapeutic effect of statins in COPD, and are planning such a trial. The study was published online on July 12, 2009, in BMC Pulmonary Medicine, a publication of BioMed Central.

"Data from our review suggest that statins may have the potential to alter prognosis for survival or decline in lung function in COPD patients - a target that is not clearly achieved with any current COPD medication,” said lead author Claudia C. Dobler, M.D. "We are currently in the process of recruiting participants for an interventional study looking at the benefits of statin treatment and dietary antioxidants in people with COPD.”

COPD is one of the leading causes of chronic morbidity and mortality around the world. The disease is usually related to smoking. The prognosis of COPD is improved after smoking cessation, though in some individuals inflammation persists. Anti-inflammatory strategies have only marginal beneficial effects on COPD, but statins have recently been recognized as possible disease-modifying agents in COPD.

Related Links:
Liverpool Hospital
Woolcock Institute of Medical Research