The effect of statin therapy on allergic patients with asthma.
BACKGROUND
3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors have significantly improved outcomes in coronary artery disease. They have anti-inflammatory and cholesterol-lowering effects. Statins alter the production of T(H)1 cytokines and thus promote a T(H)2 response. This immune alteration would promote allergic diseases such as asthma.


OBJECTIVE
To ascertain whether statin use adversely affects the clinical course of asthma.


METHODS
We retrospectively reviewed 759 medical records of consecutive patients with asthma to identify patients with extrinsic asthma who had at least 4 physician visits over 1 year. We compared patients who started receiving statins after their initial asthma evaluation with patients who never received statins. Baseline characteristics; change in forced expiratory volume in 1 second from baseline at 3, 6, 12, and 24 months; and a need for increases in medication and acute asthma visits were compared between the statin and control groups.


RESULTS
We identified 24 patients who started statin therapy and 26 control patients. There was a statistically significant 3% to 5% median worsening of forced expiratory volume in 1 second at all time points for the statin group compared with the controls. At 6 months, more patients in the statin group needed increased maintenance medication (16 [67%] vs 7 [27%]; P = .005), used albuterol more frequently (18 [75%] vs 3 [12%]; P < .001), had more nocturnal awakenings (8 [33%] vs 0 [0%]; P < .001), and were seen more frequently at office visits for acute asthma (9 [38%] vs 1 [4%]; P = .003).


CONCLUSIONS
This preliminary study demonstrated that patients with asthma who received statins had a worse clinical course than controls. Given the prevalence of both statin use and asthma, further research is needed.
Ostroukhova
Marina
M
Department of Medicine, Rochester General Hospital, Rochester, New York, USA.
Kouides
Ruth W
RW
Friedman
Elizabeth
E
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D018927:Anti-Asthmatic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors