Statins in COPD: a systematic review.
BACKGROUND
The 3-hydroxy 3-methylglutaryl coenzyme A reductase inhibitors (ie, statins) are widely used for the treatment of patients with hypercholesterolemia and cardiovascular disease. Emerging evidence suggests a beneficial effect of statins on the morbidity and mortality of patients with COPD. The objective of this study was to perform a systematic review of the literature evaluating the effect of statin therapy on outcomes in patients with COPD.


METHODS
Medline, Excerpta Medica Database, PapersFirst, and the Cochrane collaboration and Cochrane Register of controlled trials were searched. Randomized controlled trials (RCTs), observational cohort studies, case-control studies, and population-based analyses were considered for inclusion.


RESULTS
Nine studies were identified for review (four retrospective cohorts, one nested case-control study of a retrospective cohort, one retrospective cohort and case series, two population-based analyses, and one RCT). All studies showed a benefit from statin therapy for various outcomes in COPD patients, including the number of COPD exacerbations (n = 3), the number of and time to COPD-related intubations (n = 1), pulmonary function (eg, FEV(1) and FVC) [n = 1], exercise capacity (n = 1), mortality from COPD (n = 2), and all-cause mortality (n = 3). No studies describing a negative or neutral effect from statin therapy on outcomes in COPD patients were identified.


CONCLUSIONS
The current literature collectively suggests that statins may have a beneficial role in the treatment of COPD. However, the majority of published studies have inherent methodological limitations of retrospective studies and population-based analyses. There is a need for prospective interventional trials designed specifically to assess the impact of statins on clinically relevant outcomes in COPD.
Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Surinder
S
Janda
Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Kirly
K
Park
Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
J Mark
JM
FitzGerald
Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Mahyar
M
Etminan
Department of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address: swiston@interchange.ubc.ca.
John
J
Swiston
D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012107:Research Design
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors