Panminerva Medica 2020 Apr 28

DOI: 10.23736/S0031-0808.20.03932-4

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Efficacy of statin therapy in chronic obstructive pulmonary disease: a systematic review and meta-analysis from 2008-2019

Xiaoming XUE ¹, Hongyu CAI ² ✉, Zhi CHAI ³, Fang SHANG ¹, Wei GUAN ¹, Li ZHANG ¹, Xu CHEN ¹, Bobo ZHOU ¹, Luodan ZHANG ¹

¹ Department of Respiration, Shanxi Provincial Traditional Chinese Medicine Hospital, Yingze District, Taiyuan, China; ² Department of Nephropathy, Shanxi Provincial Traditional Chinese Medicine Hospital, Yingze District, Taiyuan, China; ³ Basic Medical College, Shanxi University of Chinese Medicine, University Campus, Taiyuan, China

BACKGROUND: Statins produce significant hypolipidemic effects and reduce C-reactive protein (CRP) in patients with chronic obstructive pulmonary disease (COPD). It has been reported that statins did not prevent the acute exacerbation of COPD or improve clinical outcomes. We therefore analyzed the actual therapeutic effects of statins on COPD therapy during long-term clinical trials.
METHODS: Relevant studies were retrieved from various databases from 2008 to 2019. For each study, odds ratios (ORs), mean difference (MD) and 95% confidence interval (95% CI) were assessed.
RESULTS: Thirty-two studies were retrieved with 3,137 patients receiving statin therapy and 3,140 controls. Satins significantly increased exercise capacity (47.21, 95% CI: 20.79-73.63), lung FEV1 (4.02, 95% CI: 2.28-5.75), forced expiratory volume in 1s/forced vital capacity (FEV1/FVC) (3.56, 95% CI: 2.01-5.10) and high-density lipoproteins (HDL) (5.573, 95% CI: 1.74-9.41). In addition, statins downregulated CRP function (W-1.60, 95% CI: -2.45-0.76), IL- 6 (-3.35, 95% CI: -4.94--1.76), St George's breath questionnaire (SGRQ) scores (-9.96, 95% CI: -12.83--7.10), COPD assessment test (CAT) (-3.49, 95% CI: -4.70--2.29) and systolic blood pressure (-4.992, 95% CI: -5.17--4.818). Total cholesterol (TC) (-37.84, 95% CI: -46.10- 29.58) low-density lipoproteins (LDL) (-26.601, 95% CI: -26.688-26.514) and triglycerides (TG) (-42.914, 95% CI: -61.809-24.02) were also decreased.
CONCLUSIONS: Clinical trials conducted over a 10-year period revealed beneficial advantages of statin therapy in COPD patients, permitting increased exercise capacity, FEV1/FVC and HDL. In addition, CRP, IL-6, systolic blood pressure, SGRQ scores and CAT were significantly decreased as well as lipid levels.

KEY WORDS: Statins; Chronic obstructive pulmonary disease (COPD); Meta-analysis; Lipids; C-reactive protein