Cholesterol Rx Does Not Prevent COPD Flare-Ups

Chronic obstructive pulmonary disease symptoms are not lessened by statins

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Statins have been found to reduce inflammation in blood vessels and lower risk of heart attack and stroke. Some have thought the medication could have a similar anti-inflammatory effect on COPD.

As an inflammatory lung condition, COPD (chronic obstructive pulmonary disease) makes it difficult to breathe. In analyzing existing data, some researchers have observed that statins appear to benefit COPD patients.

In a new study directly evaluating the effects of simvastatin on patients, scientists found that the cholesterol-lowering medication did not reduce the severity of COPD flare-ups.

"Talk to your doctor about how best to treat COPD symptoms."

Gerard J. Criner, MD, director of Pulmonary and Critical Care Medicine at Temple University Hospital in Philadelphia, and colleagues recruited 877 patients with moderate to severe COPD who were not already taking statins.

Ranging in age from 40 to 80, these volunteers came from 45 sites in the U.S. and Canada and were all current or former smokers.

Participants also had to meet at least one of three criteria:

  • They were taking supplemental oxygen currently or in the past.
  • They were prescribed systemic corticosteroids and/or antibiotics in the past year.
  • They had a flare-up in the past year that sent them to the ER or caused them to be hospitalized.

Those with diabetes or coronary heart disease were excluded.

Clinicians gave 430 individuals a daily dose of 40 milligrams of simvastatin, which is commonly prescribed to prevent heart attack and stroke. The remaining 447 patients took a daily placebo. Investigators followed subjects for at least 12 months and for as long as 36 months.

The primary assessment was based on exacerbation rate, or how many exacerbation events occurred per patient per year. The COPD Foundation says that an acute exacerbation (or worsening) can be identified by wheezing or more wheezing than normal, excessive coughing, shortness of breath that is worse than normal, excessive amounts of mucus, color change in mucus, shallow or rapid breathing that’s beyond the norm, fever, confusion, excessive sleepiness or swelling in feet or ankles.

Dr. Criner and his collaborators found that the COPD exacerbation rate of the simvastatin group (1.36 per year) was almost the same as that of placebo group (1.39 per year).

Simvastatin also did not impact severity of exacerbation, lung function, disease-related quality of life, rates of adverse events such as pneumonia or death rate.

The median number of days until the first exacerbation was also similar for both groups—223 days for the simvastatin takers and 231 days for the placebo people.

The only major difference noted, which the authors expected, was lower cholesterol and triglyceride levels in the statin group compared to the placebo group.

"COPD patients benefit from the use of statins just like any other group of patients that benefit from statins according to established indications to reduce cardiovascular risk," Dr. Criner said in a press release. "What this study shows is that patients who do not meet already established criteria for statin therapy should not take statins only to prevent COPD exacerbations."

Cigarette smoking is the leading cause of COPD. The disease includes emphysema, chronic bronchitis and in some cases asthma. While there is no cure, individuals can take steps to improve their breathing, including quitting smoking, eating to meet nutritional needs, exercising and taking the proper medications.

Study results were reported May 18 at the American Thoracic Society's annual international scientific meeting in San Diego and published online in The New England Journal of Medicine. The investigation was funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health and the Canadian Institutes of Health Research.

Review Date: 
May 21, 2014
Last Updated:
May 23, 2014