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. 2009 Jul 12:9:32.
doi: 10.1186/1471-2466-9-32.

Associations between statins and COPD: a systematic review

Claudia C Dobler  1 , Keith K Wong, Guy B Marks
Affiliations

Associations between statins and COPD: a systematic review

Claudia C Dobler et al. BMC Pulm Med. .

Abstract

Background: Statins have anti-inflammatory and immunomodulating properties which could possibly influence inflammatory airways disease. We assessed evidence for disease modifying effects of statin treatment in patients with chronic obstructive pulmonary disease (COPD).

Methods: A systematic review was conducted of studies which reported effects of statin treatment in COPD. Data sources searched included MEDLINE, EMBASE and reference lists.

Results: Eight papers reporting nine original studies met the selection criteria. One was a randomized controlled trial (RCT), one a retrospective nested case-control study, five were retrospective cohort studies of which one was linked with a case-control study, and one was a retrospective population-based analysis. Outcomes associated with treatment with statins included decreased all-cause mortality in three out of four studies (OR/HR 0.48-0.67 in three studies, OR 0.99 in one study), decreased COPD-related mortality (OR 0.19-0.29), reduction in incidence of respiratory-related urgent care (OR 0.74), fewer COPD exacerbations (OR 0.43), fewer intubations for COPD exacerbations (OR 0.1) and attenuated decline in pulmonary function. The RCT reported improvement in exercise capacity and dyspnea after exercise associated with decreased levels of C-reactive protein and Interleukin-6 in statin users, but no improvement of lung function.

Conclusion: There is evidence from observational studies and one RCT that statins may reduce morbidity and/or mortality in COPD patients. Further interventional studies are required to confirm these findings.

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Figures

Figure 1
Figure 1
Study selection process.
Figure 2
Figure 2
Forest plot of effect estimates of statins for ORs, HRs and RRs. RR = Risk ratio, HR = Hazard ratio, OR = Odds Ratio. Where available, adjusted estimates (OR, HR, RR) were used. Values less than 1 indicate a better outcome with statin therapy. Box size is proportional to precision of the estimate. * Mortality was only given for the whole cohort, which included 24% patients with restrictive rather than obstructive spirometry finding. ** 10-year mortality (mortality at 30 days not shown).
See this image and copyright information in PMC

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