Wen Zhang1, Yi Zhang1, Chuan-Wei Li2, Paul Jones3, Chen Wang4, Ye Fan5. 1. Department of Respiratory Disease, Xinqiao Hospital, Chongqing, China. 2. Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China. 3. Institute of Infection and Immunity, St. George's University of London, London, England. 4. Department of Respiratory Disease, Xinqiao Hospital, Chongqing, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China. 5. Department of Respiratory Disease, Xinqiao Hospital, Chongqing, China. Electronic address: fan_ye_sat@hotmail.com.
Abstract
BACKGROUND: Much controversy persists regarding the place of statin drugs in the treatment of patients with COPD. This systematic review and meta-analysis sought to determine the clinical efficacy of statin therapy in COPD. METHODS: We searched MEDLINE, EMBASE, the Cochrane Database, and PubMed for relevant clinical studies. Randomized controlled trials (RCTs) comparing the effects of statin drugs with placebo in COPD populations were included. Pooled estimates were calculated using a random-effects model. Heterogeneity was determined using the I2 statistic. RESULTS: Ten trials with a total of 1,471 patients were included. Statin treatment was associated with a larger improvement in exercise capacity, lung function, and St. George's Respiratory Questionnaire score compared with placebo, but there were no statistically significant differences in inflammatory markers, all-cause mortality, and safety outcomes; however, subgroup analysis indicated that statin drugs improved clinical outcomes in the subjects from trials enrolling patients with overt cardiovascular disease (CVD), elevated baseline C-reactive protein levels, or a high cholesterol level. CONCLUSIONS: The findings from this systematic review suggest a role for statin drugs in patients with COPD and coexisting CVD, evidence of increased systemic inflammation, or hyperlipidemia with respect to improving exercise tolerance and pulmonary function. These findings need to be confirmed by RCTs specifically designed to test this hypothesis and identify appropriate patients for statin use. TRIAL REGISTRY: PROSPERO: CRD42017060594; https://www.crd.york.ac.uk/PROSPERO/.
BACKGROUND: Much controversy persists regarding the place of statin drugs in the treatment of patients with COPD. This systematic review and meta-analysis sought to determine the clinical efficacy of statin therapy in COPD. METHODS: We searched MEDLINE, EMBASE, the Cochrane Database, and PubMed for relevant clinical studies. Randomized controlled trials (RCTs) comparing the effects of statin drugs with placebo in COPD populations were included. Pooled estimates were calculated using a random-effects model. Heterogeneity was determined using the I2 statistic. RESULTS: Ten trials with a total of 1,471 patients were included. Statin treatment was associated with a larger improvement in exercise capacity, lung function, and St. George's Respiratory Questionnaire score compared with placebo, but there were no statistically significant differences in inflammatory markers, all-cause mortality, and safety outcomes; however, subgroup analysis indicated that statin drugs improved clinical outcomes in the subjects from trials enrolling patients with overt cardiovascular disease (CVD), elevated baseline C-reactive protein levels, or a high cholesterol level. CONCLUSIONS: The findings from this systematic review suggest a role for statin drugs in patients with COPD and coexisting CVD, evidence of increased systemic inflammation, or hyperlipidemia with respect to improving exercise tolerance and pulmonary function. These findings need to be confirmed by RCTs specifically designed to test this hypothesis and identify appropriate patients for statin use. TRIAL REGISTRY: PROSPERO: CRD42017060594; https://www.crd.york.ac.uk/PROSPERO/.
Authors: Sophia Kwon; Myeonggyun Lee; George Crowley; Theresa Schwartz; Rachel Zeig-Owens; David J Prezant; Mengling Liu; Anna Nolan Journal: Am J Respir Crit Care Med Date: 2021-11-01 Impact factor: 21.405
Authors: Jesús Recio Iglesias; Jesús Díez-Manglano; Francisco López García; José Antonio Díaz Peromingo; Pere Almagro; José Manuel Varela Aguilar Journal: Int J Chron Obstruct Pulmon Dis Date: 2020-05-07
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