Abstract

BACKGROUND: Much controversy persists regarding the place of statins in the treatment of patients with chronic obstructive pulmonary disease (COPD). This systematic review and meta-analysis sought to determine the clinical efficacy of statin therapy in COPD. METHODS: We searched Medline, Embase, Cochrane databases, and Pubmed for relevant clinical studies. Randomized controlled trials comparing the effects of statins to placebo in COPD populations were included. Pooled estimates were calculated using a random-effects model. Heterogeneity was determined using the I(2) statistic. RESULTS: Ten trials with a total of 1471 patients were included. Statin treatment was associated with a larger improvement in exercise capacity, lung function, and St. George's Respiratory Questionnaire score compared with placebo, but there were no statistically significant differences in inflammatory markers, all-cause mortality, and safety outcomes; however, subgroup analysis indicated that statins improved clinical outcomes in the subjects from trials enrolling patients with overt cardiovascular disease, elevated baseline C-reactive protein, or high level of cholesterol. CONCLUSIONS: The findings from this systematic review suggest a role for statins in COPD patients with coexisting cardiovascular disease, evidence of increased systemic inflammation, or hyperlipidemia, in terms of improving exercise tolerance and pulmonary function. These findings need to be confirmed by randomized controlled trials specifically designed to test this hypothesis and identify appropriate patients for statin use.