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Statins for COPD

People with chronic obstructive pulmonary disease (COPD) have inflamed airways and that causes much discomfort and lower quality of life. Steroid anti-inflammatory medication, effective for problems in many parts of the body, do not work well for COPD symptoms. Why not try statins? It is known that statins have anti-inflammatory effects, even if these are considered pleiotropic – beneficial side effects – and not part of why statins are prescribed.

Many people with COPD are taking statins anyway for their cholesterol. Scientists in The Netherlands did an observational study comparing COPD patients who use statins with those who do not. This was called the Rotterdam study. They looked at patients’ serum hs-CRP levels, which are a biomarker for COPD inflammation. Patients who had high hs-CRP levels showed a risk in mortality when they used statins. Patients with low inflammation indication showed no substantial benefit.

A retrospective study of Norwegian patients found COPD patients who took statins had a lower mortality rate than those who did not, but this wasn’t necessarily due to any interaction with the COPD. We already knew statins lower the risk of dying from stroke.

A small double-blind study of a small (20 mg/day) dose of simvastatin over a period of 6 weeks found no significant effect on COPD symptoms suggesting that higher doses or longer time periods may be required to see a difference. Indeed, the Rotterdam study found that a statin regimen of over 2 years was required to see benefits.

Another problem is that COPD symptoms often get worse when a patient is in the hospital. Chinese scientists found that people who had been taking statins were less apt to experience this exacerbation in the hospital. You can’t just start taking the statins when you go into the hospital, but if you have been using them recently, you did better off. The higher the statin does, the bigger the effect.

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