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

INTRODUCTION: 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. Therefore, we analyzed the actual therapeutic effects of statins on COPD therapy during long-term clinical trials.EVIDENCE ACQUISITION: 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.EVIDENCE SYNTHESIS: Thirty-two studies were retrieved with 3137 patients receiving statin therapy and 3140 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 1 s/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 to -1.76), St George's breath questionnaire (SGRQ) scores (-9.96, 95% CI: -12.83 to -7.10), COPD assessment test (CAT) (-3.49, 95% CI: -4.70 to 2.29) and systolic blood pressure (-4.992, 95% CI: -5.17 to -4.818). Total cholesterol (TC) (-37.84, 95% CI: -46.10 to 29.58) low-density lipoproteins (LDL) (-26.601, 95% CI: -26.688 to 26.514) and triglycerides (TG) (-42.914, 95% CI: -61.809 to 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.