Statins versus placebo for people with chronic obstructive pulmonary disease

Walsh, Aisling; Perrem, Lucy; Elshafi, Mohamed; Khashan, Ali S.; Henry, Michael T.; Chróinín, Muireann Ní

doi:10.1002/14651858.cd011959.pub2

Cited by 27 publications

(31 citation statements)

References 81 publications

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“… 12 While observational studies have shown promising results with reduced exacerbations and mortality in COPD patients, RCTs fail to show an effect. 9 However, many studies focus on COPD patients without concurrent CVD and often using short (<365 days) follow-up time. 9 Considering the high CVD burden in COPD, it can be argued that the populations in these studies are not representative of real-world COPD populations where CVD comorbidity is exceedingly common.…”

Section: Introductionmentioning

confidence: 99%

“… 9 However, many studies focus on COPD patients without concurrent CVD and often using short (<365 days) follow-up time. 9 Considering the high CVD burden in COPD, it can be argued that the populations in these studies are not representative of real-world COPD populations where CVD comorbidity is exceedingly common. As such, both observational and RCT studies are needed to elucidate the effect of statin treatment on COPD in real-world settings.…”

Section: Introductionmentioning

confidence: 99%

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Statins in High-Risk Chronic Obstructive Pulmonary Disease Outpatients: No Impact on Time to First Exacerbation and All-Cause Mortality – The STATUETTE Cohort Study

Damkjær¹,

Håkansson²,

Kallemose³

et al. 2021

COPD

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Background Statins have, due to their anti-inflammatory properties, been suggested to potentially improve chronic obstructive pulmonary disease (COPD) outcomes. We aimed to investigate the effect of statins on time to first exacerbation and all-cause mortality in high-risk COPD outpatients. Methods All outpatients with COPD seen at the Department of Respiratory Medicine, Copenhagen University Hospital Amager and Hvidovre, Denmark in 2016 were identified and followed for 3.5 years in this retrospective, registry-based cohort study of time to first acute exacerbation of COPD (AECOPD) or death. AECOPD was defined as a rescue course of oral corticosteroid and/or hospital admission. The association was estimated using time-varying crude and multivariable Cox proportional hazard regression. Results The cohort comprised 950 COPD outpatients, mean (SD) age 71 (11) years, and FEV1 44% predicted (IQR 33%; 57%). The annual exacerbation rate was 0.88 (1.68) and 211 patients (22%) had a history of hospital admission for AECOPD in the 12 months prior to index date. Three hundred and ninety-three patients (41.4%) were defined as statin users, with 131 (33.3%) having filled the first prescription for statin after index date. Statin use was not associated with reduced risk of AECOPD. When stratifying for moderate and severe exacerbations in a sub-analysis in the same model, statin use did not have an increased HR for exacerbation of either severity (HR = 1.02 (95% CI 0.85to 1.24; p = 0.811) and HR = 1.07 (95% CI 0.89 to 1.29; p = 0.492) respectively). Statin use was not associated with all-cause mortality (HR 1.05 (95% CI, 0.75 to 1.47, p = 0.777)). Conclusion We did not find any association between statin use and risk of AECOPD or all-cause mortality. The result adds to the evidence that an aggressive approach with statin treatment upfront is not beneficial in COPD, unless prescribed according to current guidelines for cardiovascular diseases.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Statins in High-Risk Chronic Obstructive Pulmonary Disease Outpatients: No Impact on Time to First Exacerbation and All-Cause Mortality – The STATUETTE Cohort Study

Damkjær¹,

Håkansson²,

Kallemose³

et al. 2021

COPD

View full text Add to dashboard Cite

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“…Many studies had previously shown the anti-in ammatory effect of statin (23,24), but few studies could not demonstrate this effect (25,26). Considering the signi cant reduction in serum cholesterol level in Atorvastatin group it is unlikely that poor adherence to the study protocol could explain the failure to reach statistical difference between groups.…”

Section: Discussionmentioning

confidence: 96%

The Effect of Atrovastatin on Inflammatory Markers in Sulfur Mustard Gas Induced Bronchitis; A Randomized Double-Blinded, Placebo-Controlled Clinical Trial

Momeni

Nazer

Masoompour

et al. 2020

Preprint

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Background: This study was conducted to evaluate the anti-inflammatory effect of atorvastatin in patients with chronic bronchitis due to sulfur mustard gas inhalation. Methods: In this randomized double-blinded clinical trial we enrolled patients with chronic bronchitis due to sulfur mustard gas inhalation. Ninety man aged between 45 to 75 years with diagnosed of chronic bronchitis due to exposure to mustard gas during the Iran-Iraq war, were randomly assigned to receive either atorvastatin (40 mg) or placebo, given orally once a day for 3 months. The interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), procalcitonin, highly sensitive CRP, and COPD assessment test (CAT) score in both groups compared with each other and baseline data. Results: After 12 weeks of using atorvastatin (n=40), the level IL-6 decreased significantly (p=0.03) without any significant differences in the level of TNF-α, high sensitive CRP, and procalcitonin (P=0.31, p=0.78, and p=0.08). In placebo group (n=38), both procalcitonin and IL-6 significantly decreased after 12 weeks (P=0.002 and p<0.001), but levels of high sensitive CRP did not differ significantly and the level of TNF-α increased (p=0.006). The mean differences in levels of TNF- α, IL-6, high sensitive CRP, and procalcitonin did not differ statistically significant between the study groups after 12 weeks. Although after 12 weeks of study in both groups the CAT score have had appreciably high magnitude decrease (P<0.001), but its mean differences change wasn't significant between group (P=0.71). Conclusions: Administration of 40 mg atorvastatin for 3 months although could not significantly change systemic inflammatory markers or quality of life in mustard gas induced chronic bronchitis.Trial registration: IRCT, IRCT138904144312N1. Registered 16 August 2014, https://en.irct.ir/trial/4577

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“…In one hand, several studies could show the anti-in ammatory effect of statin (26,27); however, few could not (28,29). Considering the signi cant reduction in serum cholesterol level in the atorvastatin group, it is unlikely that poor adherence to the study protocol was the reason for the failure to reach statistical differences between groups.…”

Section: Discussionmentioning

confidence: 99%

The effect of atorvastatin on inflammatory markers in sulfur mustard gas induced bronchitis; a randomized double-blinded, placebo-control clinical trial

Momeni

Nazer

Masoompour

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: This study was performed to evaluate the anti-inflammatory effect of atorvastatin in patients with chronic bronchitis, exposed to sulfur mustard gas. Methods: In this randomized double-blinded clinical trial we recruited patients with chronic bronchitis after exposure to sulfur mustard gas. Ninety men 45-75 years old diagnosed with chronic bronchitis after exposure to mustard gas during the Iran-Iraq war, were randomly assigned to receive either atorvastatin (40 mg) or placebo once a day for 3 months. The interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), procalcitonin, highly sensitive CRP and COPD assessment test (CAT) score was compared at baseline and after 12 weeks. Results: After consuming atorvastatin for 12 weeks, IL-6 level (mean difference [95%CI]; 0.2[-0.05, 0.5]), TNF-α(mean difference [95%CI]; -0.07[-0.2, 0.07]), high sensitive CRP(mean difference [95%CI] -0.1[-1.2, 0.9]), and procalcitonin (mean difference [95%CI]; 0.003[-0.02, 0.03]) did not change significantly. However, in the placebo group, only IL-6 (mean difference [95%CI]; 0.6[0.2, 1.05]) decreased significantly after 12 weeks, but levels of high sensitive CRP (mean difference [95%CI]; -0.3[-1.4, 0.8]) TNF-α (mean difference [95%CI]; -0.2[-0.34, -0.06]) and procalcitonin (mean difference [95%CI]; 0.02[-0.001, 0.04]) did not change significantly. After 12 weeks, the mean differences in TNF- α, IL-6 level, high sensitive CRP, procalcitonin, and CAT score did not significantly differ between the two groups. Conclusions: The administration of 40 mg atorvastatin for 3 months did not significantly change the inflammatory markers or the quality of life of patients exposed to mustard gas with chronic bronchitis.Trial registration: IRCT, IRCT138904144312N1. Registered 16 August 2014, https://en.irct.ir/trial/4577

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Statins versus placebo for people with chronic obstructive pulmonary disease

Cited by 27 publications

References 81 publications

Statins in High-Risk Chronic Obstructive Pulmonary Disease Outpatients: No Impact on Time to First Exacerbation and All-Cause Mortality – The STATUETTE Cohort Study

Statins in High-Risk Chronic Obstructive Pulmonary Disease Outpatients: No Impact on Time to First Exacerbation and All-Cause Mortality – The STATUETTE Cohort Study

The Effect of Atrovastatin on Inflammatory Markers in Sulfur Mustard Gas Induced Bronchitis; A Randomized Double-Blinded, Placebo-Controlled Clinical Trial

The effect of atorvastatin on inflammatory markers in sulfur mustard gas induced bronchitis; a randomized double-blinded, placebo-control clinical trial

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