A recent review showed that the long-term use of statins reduced the risk of acute exacerbation in chronic obstructive pulmonary disease (COPD), heart disease–related mortality and all-cause mortality, as well as decreased inflammatory factors.
A recent review showed that the long-term use of statins reduced the risk of acute exacerbation in chronic obstructive pulmonary disease (COPD), heart disease—related mortality and all-cause mortality, as well as decreased inflammatory factors.
It is already known that comorbidities worsen outcomes in COPD, and the researchers noted that cardiovascular disease (CVD) is prevalent in patients with COPD. Pulmonary hypertension (PH), in particular, is one of the most severe accompanying illnesses.
In addition, the authors said there is a growing understanding of systemic inflammation in a subset of patients with COPD, and they said high levels of C reactive protein (CRP) and IL-6 have been associated with poor outcomes.
The authors conducted a meta-analysis to produce polled estimates of the effect of mortality, inflammatory factors, and lung function index in COPD patients by searching 4 databases (PubMed, Web of Science, Embase, and China National Knowledge Infrastructure) between January 1990 to March 2018.
Researchers also conducted a network meta-analysis to synthetically compare the effectiveness of using different statins in patients with COPD.
Studies were included if they met 6 criteria:
Out of 988 studies, the researchers settled on a final number of 53 to use in the analysis. The analysis showed that using statins reduced the risk of all-cause mortality, heart disease-related mortality and acute exacerbation in COPD. The RRs (95% CI) were 0.72 (0.63,0.84), 0.72 (0.53,0.98), and 0.84 (0.79,0.89), respectively.
Using statins reduced CRP and PH in COPD patients. The standardized mean difference (95% CI) were —0.62 (–0.52,–0.72) and –0.71 (–0.85,–0.57), respectively.
Network meta-analysis showed that fluvastatin (97.7%), atorvastatin (68%), and rosuvastatin (49.3%) had higher cumulative probability than other statins in reducing CRP in COPD patients. Fluvastatin (76%) and atorvastatin (75.4%) had higher cumulative probability than other satins in reducing PH in COPD patients.
The researchers said their study answers whether statins can reduce inflammation and PH, and which statin is more effective for COPD.
Lu Y, Chang R, Yao J, Xu X, Teng Y, Cheng N. Effectiveness of long-term using statins in COPD - a network meta-analysis. [published online January 23, 2019]. Respir Res. doi:10.1186/s12931-019-0984-3.