Simvastatin in the treatment of asthma: lack of steroid-sparing effect

Abstract

Background Statins have anti-inflammatory actions which in theory are potentially beneficial in asthma. Small trials have failed to show a significant benefit, but a systematic study to evaluate the steroid-sparing effect of statin treatment has not been carried out. Methods A randomised, placebo-controlled, crossover trial was conducted of simvastatin 40 mg at night with simultaneous stepwise reduction of fluticasone propionate dose until loss of control occurred, followed by an increase until regain of control ('minimum' dose required) in 51 patients with asthma and sputum eosinophils (steroid-free) $2%.

Statin therapy does not improve lung function in asthma: A meta-analysis of randomized controlled trials

“…11,17,19,20 There was no significant heterogeneity among the four trials before ( 2 ¼ 1.29, I 2 ¼ 0%; Figure 1) and after ( 2 ¼ 0.38, I 2 ¼ 0%; Figure 2) ICS. Compared with the control group, the FEV 1 of the statin group was 0.09 l (95% CI À0.06, 0.23) higher before ICS.…”

“…There were three trials with a crossover study design. 11,19,20 Two trials compared atorvastatin with placebo 11,20 and two compared simvastatin with placebo. 17,19 Characteristics of the included trials are shown in Table 1.…”

“…23 A total of 200 patients were included over the remaining four trials. 11,17,19,20 The sample size ranged between 43 and 64. There were three trials with a crossover study design.…”

“…After scanning the titles and abstracts, 500 were excluded and five eligible randomized controlled trials were identified. 11,17,19,20,23 After reading the full texts, one of the five studies was excluded because it used a Wilcoxon test. 23 A total of 200 patients were included over the remaining four trials.…”

“…11,17,19,20 To date, there have been few published randomized controlled trials on the efficacy of statins in the treatment of asthma, and the number of included cases has ranged between 43 and 64. 11,17,19,20 Moreover, the conclusions of these studies differ. The present meta-analysis of these four randomized controlled trials assessed the efficacy of statins in the treatment of asthma.…”