Effects of simvastatin in chronic obstructive pulmonary disease: Results of a pilot, randomized, placebo-controlled clinical trial

Abstract

IntroductionStatins may have pleiotropic effects in COPD, but mechanisms remain unclear.ObjectivesTo assess the pleiotropic effect of statins in patients with stable COPD on (1): lung function (2); pulmonary and systemic inflammation (3); endothelial function (vascular stiffness) and circulating vascular growth factors; and (4), serum uric acid levels.MethodPilot, double-blind, randomized, placebo-controlled clinical trial in 24 patients with stable COPD, all statin-naïve, who were randomized (1:1) to receive simvastatin 40 mg/24 h during 12 weeks (n = 12; 69.0 ± 7.3 years; post-bd FEV1 53.4 ± 10.0% pred.) or placebo (n = 12; 66.4 ± 4.6 years; post-bd FEV1 48.2 ± 12.6% pred.). Nine patients per group (total n = 18) completed the study.ResultsLung function, pulmonary and systemic inflammatory markers and the degree of vascular stiffness did not change significantly in any group. However, treatment with simvastatin increased the plasma levels of erythropoietin (Epo) (4.2 ± 2.2 mIU/mL to 6.8 ± 3.2 mlU/mL, p < 0.05) and reduced those of serum uric acid (7.1 ± 1.3 mg/dL to 6.5 ± 1.4 mg/dL, p < 0.01).ConclusionsShort-term treatment with simvastatin in stable COPD patients did not modify lung function, pulmonary and systemic inflammation, or vascular stiffness, but it changed Epo and uric acid levels.

Association Between Statin Use and Exacerbation of Chronic Obstructive Pulmonary Disease Among Patients Receiving Corticosteroids

“… 12 Another two randomized controlled trials pointed out statins did not improve in pulmonary function. 16 , 17 …”

“…12 Another two randomized controlled trials pointed out statins did not improve in pulmonary function. 16,17 Some of the studies demonstrated that statins are particularly effective in COPD patients with cardiovascular comorbidity. 2,9,18 There is no doubt that COPD and cardiovascular comorbidity are often co-existed, especially more severe severity of COPD.…”

Regulation of ATP binding cassette transporter A1 (ABCA1) expression: cholesterol-dependent and – independent signaling pathways with relevance to inflammatory lung disease

“…Statins were postulated as possible treatment for inflammatory lung diseases including COPD. However, clinical trials like STATCOPE were shown to have an overall insignificant impact on patient outcomes [21,112,113]. Previous studies have looked at whether the reason behind the statins' inability to significantly reduce inflammation during pulmonary exacerbation is linked with ABCA1 being downregulated as a result of statin treatment [1,4,37].…”

Effect of Statins on COPD

“…Ultimately, 10 of the 20 studies were selected 4-5, 11, 14-20 ; of those not included, three were excluded because they did not use a placebo control [21][22][23] , three because they used the same dataset as another study included in this meta-analysis [24][25][26] , one because it was a post-hoc analysis of a large statin-heart failure RCT 27 , one because one-quarter of the recruited patients did not complete the study 28 , one because most of the patients did not fulfil GOLD criteria for COPD 29 , and one because no outcomes of interest were reported 30 . All the included trials were published as peer-reviewed articles, and all of them were in English.…”