Cholesterol-lowering drug may benefit COPD patients

Chronic obstructive pulmonary disease (COPD), a common condition of the elderly affecting an estimated 10 % of those over the age of 60 years, is characterized by an accelerated long-term decline in lung function due to inflammation-induced lung damage. Arterial blood gases are routinely used to monitor patients with advanced disease as well those suffering periodic acute exacerbations. 

Despite active research, there remains no specific drug treatment that prevents or reduces the accelerated decline in lung function towards eventual respiratory failure, although quitting smoking is beneficial in this regard. 

A recently published study now suggests that statins, the class of cholesterol-lowering drugs commonly prescribed for patients suffering, or at risk of suffering, coronary heart disease, may be effective in slowing the decline in lung function among patients with COPD. The notion that statins may be effective in COPD is born of research that has confirmed the anti-inflammatory and antioxidant pleiotropic effect of statin drugs. 

For this second-ever study of the effect of statins on the decline in lung function, the authors identified statin users and non-users among a cohort of 803 elderly men (average age 71 years) whose lung function (forced expiratory volume in 1 second, FEV1 and forced vital capacity, FVC) had been measured at least twice (up to four times in some cases), between 1995 and 2005. 

For those not taking statins, the estimated decline in FEV1 was 23.9 mL/year (range –27.8 to –20.1 mL/year), whereas the FEV1 of those taking statins declined by just 10.9 mL/year (range –16.9 to –5.0 mL/year). Very similar results were seen when FVC was used as the measure of lung function. The benefit of statins was evident in smokers as well as non-smokers. 

A randomized, placebo-controlled clinical trial of statin use in COPD patients is now urgently needed to confirm that this commonly used, inexpensive drug with few adverse effects slows the progress of this common devastating disease, as the results of this and another study suggest.