Effect of statins on pulmonary function in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials

Abstract

Background Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease, and its treatment is still controversial. Statins have been proven to have anti-inflammatory and immunomodulatory effects, but their effectiveness in the treatment of COPD is still unclear. We conducted this meta-analysis to more accurately evaluate the therapeutic effect of statins on COPD patients. Methods Randomized controlled studies published in PubMed, Cochrane Library, Embase, Wiley Online Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases from inception to July 2022 were retrieved to evaluate the effect of statins on COPD patients. Two evaluators conducted literature screening based on inclusion and exclusion criteria, and conducted a bias risk assessment on them. Meta analysis was conducted using Stata17.0 statistical software. Results A total of 1,463 patients from 10 studies were included. After statin treatment, the percentage of predicted forced expiratory volume in the first second (FEV1%pred) of COPD patients was improved [weighted mean difference (WMD): 7.89; 95% confidence interval (CI): 7.19–8.60; P<0.05], and the level of the inflammatory factor C-reactive protein (CRP) decreased (WMD: −0.63; 95% CI: −1.84, 0.58; P<0.05). The 6-minute walking distance (6MWD) of patients in the statin treatment group demonstrated a significant benefit (WMD: 26.27; 95% CI: 24.02–28.51; P<0.05). Compared to the placebo control group, statins significantly reduced COPD Assessment Test (CAT) (WMD: −2.45; 95% CI: −3.62, −1.27). Conclusions Preliminary evidence suggests that statins may have a certain effect on improving lung function, reducing inflammatory factor levels, and improving clinical symptoms in COPD patients. However, due to the quality and quantity limitations of the included studies, these results need to be further verified through a larger, higher quality randomized controlled trial (RCT).

Nadciśnienie tętnicze i jego leczenie a prewencja zaburzeń funkcji poznawczych — rola połączenia walsartanu i amlodipiny. Przegląd dla lekarza praktyka

“…W badaniu autorstwa Li i wsp., obejmującym 7566 (kohorta 1) oraz 9294 (kohorta 2) uczestników w średnim wieku -odpowiednio 62 (55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72) i 65 (58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72) lat, których obserwowano przez okres 8 lat, także oceniano wpływ ciśnienia tętniczego na ryzyko wystąpienia demencji. Stwierdzono, że wraz ze zwiększeniem skurczowego ciśnienia tętniczego (przedziały kwartylowe) ryzyko wystąpienia demencji wzrastało istotnie o 38-98%.…”

“…również zaobserwowali, że stosowanie walsartanu (160 mg) wraz z amlodipiną (10 mg) było związane ze zmniejszeniem PP i PWV [64]. Warto też wspomnieć o wynikach metaanalizy 10 randomizowanych badań klinicznych, którą przeprowadzili Chen i wsp., w której stwierdzono, że sartany (reprezentowane głównie przez walsartan) wykazywały się największym spośród innych klas leków przeciwnadciśnieniowych wpływem na obniżenie współczynnika wzmocnienia (AI, augmentation idex), który jest wykładnikiem sztywności naczyń (p = 0,01) [65].…”

Inhaled treprostinil in pulmonary hypertension associated with COPD: PERFECT study results

“…There have been numerous studies evaluating various pulmonary arterial hypertension (PAH) therapies in COPD patients, but most of these have been small, open-label or retrospective. Nonetheless, two meta-analyses of these trials have suggested a treatment benefit [ 4 , 5 ]. There have been very few randomised controlled studies for PH-COPD; one small study of sildenafil was positive, but a larger study of tadalafil was negative [ 6 – 8 ].…”

Inflammation and immunity in the pathogenesis of hypoxic pulmonary hypertension

“…With a combination of targeted drugs (3) such as phosphodiesterase-5 inhibitors, endothelin receptor antagonists, prostacyclin analogs, and prostacyclin receptor agonists, patients with pulmonary arterial hypertension (PAH, i.e., WHO group I PH) have shown a significant improvement in activity tolerance and disease prognosis. However, clinical trials of these drugs have not shown any beneficial effects in patients with HPH (4,5). Therefore, clarifying the underlying pathogenic mechanisms in this group of patients will help to improve targeted therapies.…”