Are Statins Effective In Reducing COPD Flares?

Dr. Gerard J. Criner MD, FACP, FACCP Professor, Medicine Director, Medical Intensive Care Unit and Ventilator Rehabilitation Unit Co-Director, Center for Inflammation, Translational and Clinical Lung Research Temple University Hospital in Philadelphia, PAMedicalResearch Interview with:
Dr. Gerard J. Criner MD, FACP, FACCP
Professor, Medicine
Director, Medical Intensive Care Unit and Ventilator Rehabilitation Unit
Co-Director, Center for Inflammation, Translational and Clinical Lung Research, Temple University Hospital in Philadelphia, PA

MedicalResearch: What are the main findings of the study?

Dr. Criner: The STATCOPE Trial (Simvastatin in the Prevention of COPD Exacerbations) found that a statin drug commonly used to lower cholesterol is not effective in reducing the number and severity of flare ups from chronic obstructive pulmonary disease (COPD).   The study rigorously tested the hypothesis that statin drugs may be beneficial to persons with COPD because of the drugs’ purported anti-inflammatory effect.  However, researchers found that:

  • 40 mg. of daily simvastatin (statin drug) added to usual care did not reduce exacerbation rate or prolong the time to exacerbation in patients with moderate to severe COPD.
  • Simvastatin had no effect on lung function, quality of life, severe adverse events or mortality.
  • The data do not demonstrate a therapeutic benefit from statins in patients with moderate to severe COPD.

MedicalResearch: Were any of the findings unexpected? 

Dr. Criner: Yes, based on the large body of observational and retrospective data we believed that statins would have a potent anti-inflammatory effect especially in COPD patients with active exacerbation history.  However we found no effect of statins in reducing the number of exacerbations nor their severity.  Any other parameter that could be associated with an improved benefit, such as lung function or quality of life were similarly not affected.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Criner: The main takeaway for clinicians and patients is that patients who do not meet already established criteria for statin therapy should not take statins only to prevent COPD exacerbations.  This study suggests that statins’ purported non-cholesterol-lowering anti-inflammatory effects do not extend to COPD.  However, it is important to note that the finding that the statin drug has no benefit for prevention of COPD exacerbations does not mean that COPD patients should stop taking statins prescribed for cholesterol lowering or other cardiovascular indications.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Criner: Information gleaned from this study should help inform other research into the inflammatory nature of COPD.  These findings will allow us to pursue other avenues of anti-inflammatory treatment so we can develop new therapies that are so desperately needed.  More work is currently being done and planned to be done that will target more viable pathways and mechanisms to prevent or alleviate the consequences of COPD exacerbations

Citation:

Simvastatin for the Prevention of Exacerbations in Moderate-to-Severe COPD
Gerard J. Criner, M.D., John E. Connett, Ph.D., Shawn D. Aaron, M.D., Richard K. Albert, M.D., William C. Bailey, M.D., Richard Casaburi, M.D., Ph.D., J. Allen D. Cooper, Jr., M.D., Jeffrey L. Curtis, M.D., Mark T. Dransfield, M.D., MeiLan K. Han, M.D., Barry Make, M.D., Nathaniel Marchetti, D.O., Fernando J. Martinez, M.D., Dennis E. Niewoehner, M.D., Paul D. Scanlon, M.D., Frank C. Sciurba, M.D., Steven M. Scharf, M.D., Ph.D., Don D. Sin, M.D., M.P.H., Helen Voelker, B.A., George R. Washko, M.D., Prescott G. Woodruff, M.D., and Stephen C. Lazarus, M.D. for the COPD Clinical Research Network and the Canadian Institutes of Health Research

May 18, 2014DOI: 10.1056/NEJMoa1403086

 

 

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