Statins in COPD: Useful or Not?


Statins were developed 3 decades ago to control blood cholesterol and its components, and thus reduce the risks for myocardial and other vascular events. That goal has been achieved successfully. With the widespread use of statins, it soon became clear that these drugs might have other actions, with anti-inflammatory action being one possibility.

Some benefit from the use of statins has been reported in other disorders with inflammatory features. The present trial was a prospective, randomized, double-blind, placebo-controlled trial in 885 patients with moderate to severe chronic obstructive pulmonary disease (COPD) who had experienced an acute exacerbation in the previous year and did not require statin therapy for another diagnosis. Study patients received either 40 mg of simvastatin per day or placebo. The number of exacerbations per person, per year was the primary outcome.

The study was terminated prematurely because interim analysis of the results showed that the frequency of acute exacerbations was almost identical in the 2 groups, as was the time to first exacerbation. Mortality and adverse events were also almost identical in the 2 groups. Blood lipid levels decreased by an average of 33 mg/dL in the statin group. This indicated the use of a statin and that it had the expected effect on blood lipid levels. The total study results were disappointing.

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