Could Statins Improve COPD Outcomes?

Chronic Obstructive Pulmonary Disease (COPD) affects 380 million people around the world, and those numbers are increasing every year.¹ COPD is a chronic, progressive disease of the lungs for which there is no known cure. Standard treatments can lessen symptoms and slow the progression at times but do not cure the underlying disease.

For those reasons, people who have COPD are often on the lookout for new and promising treatment strategies for their lung disease. Growing numbers of studies now suggest that statins, medicines developed to treat high cholesterol and other heart problems, may improve lung function and COPD outcomes.

COPD and heart disease are often linked

It is well-known that COPD and heart disease often occur together. We also know that having both is linked to worse outcomes than having only one of the conditions.² Cardiovascular disease and pulmonary hypertension (a type of high blood pressure) are common in people with COPD.

In addition, we know that inflammation is part of the COPD disease process.

Statins are commonly used in heart patients and to treat high cholesterol levels. Previous studies show that COPD patients who took statins were living longer and had fewer flares, but researchers were not sure why.³ This led Chinese researchers to look more closely at the possible reasons behind these results.

Details of the recent study on statins and COPD

Chinese researchers this year published a study called "Effectiveness of long-term using statins in COPD" – a network meta-analysis, in the Respiratory Research journal.³ A meta-analysis is a process where researchers pull together results from a number of similar studies. They look to see if there are any conclusions that can be drawn from looking at all the studies together.

Here are the details of this meta-analysis:

• 988 different studies were pulled for analysis
• Studies used were published between January 1990 and March 2018
• 53 out of the 988 studies made the "final cut" for comparison and analysis
• Causes of death statistics were examined
• Other factors compared included inflammatory markers, exercise tolerance, COPD flare frequency and other conditions such as cholesterol level and high blood pressure
• Studies ranged from small (40 patients) to very large (68, 754 patients)
• Duration of the studies ranged from 1 month to 10 years

Results of the analysis

As a result of their analysis, the Chinese researchers found that although taking statins did not seem to reduce death from heart disease in COPD patients, it did have a positive effect on overall health:³

• Overall death rate decreased by 28%
• COPD-linked death also decreased by 28%
• Acute COPD exacerbations were reduced by 16%

They also found that there were significant reductions in all inflammatory markers as a result of statin use. In addition, they noted that certain statins were especially effective in reducing the levels of C-reactive protein (CRP). These are one of the most commonly studied inflammatory markers for COPD. These statins include:

• Fluvastatin
• Atorvastatin
• Rosuvastatin

Other benefits of statin treatment in people with COPD included:

• Reduced pulmonary hypertension
• Better lung function
• Improved exercise tolerance

Long-term use of statins can benefit COPD patients

The results of this latest study suggest that long-term use of statins can benefit COPD patients in a couple of possible ways:

• They may work to slow or prevent disease progression
• They may slow or prevent co-morbid conditions

In fact, the researchers wrote: "Using statins can reduce the risk of mortality, the level of CRP and PH [pulmonary hypertension] in COPD patients. In addition, Fluvastatin and Atorvastatin are more effective in reducing CRP and PH in COPD patients."³

So, could statins be helpful for you? The answer to that will have to come from your physician. Statins, like any medication, can have side effects. So, they may not be right for every person. But they are widely used, so it's certainly worth asking your doctor if they might be right for you.