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DOI: 10.1055/s-0037-1598498
Impact of statins on lung function decline in idiopathic pulmonary fibrosis (IPF)
Publikationsverlauf
Publikationsdatum:
23. Februar 2017 (online)
Background:
Previously published data suggest that statin use might attenuate pulmonary function decline in IPF while other reports discuss the potential of statins to increase susceptibility to interstitial lung diseases.
Aim:
To assess the clinical relevance of statins in IPF.
Methods:
Patients randomly assigned to placebo in 3 large, controlled trials of pirfenidone in IPF (CAPACITY 004 & 006, ASCEND) were categorized by statin use. Groups were analyzed for mortality, hospitalization, decrease in FVC and 6MWD and progression-free survival (FVC decrease ≥10%, 6MWD decrease ≥50 m, or death) in a post-hoc analysis.
Results:
Of a total of 624 patients, 276 (44%) were statin users and 348 (56%) non-users. Groups were similar with regards to age, sex and physiologic measures at baseline but differed in relevant comorbidities, mainly cardiovascular disease and its risk factors. In univariate analyses, FVC decrease ≥10% or death differed significantly between groups favoring statin use (HR = 0.7; p = 0.012), while for progression-free survival there was a trend in favor of statins (HR = 0.8; p = 0.074). A significantly greater proportion of patients in the non-statin users (54.9%) had a relative decline in FVC % predicted of ≥5% compared to the statin users (48.6%, p = 0.038), while there was no difference in mean FVC decline (p = 0.276). For statins, multivariate analyses showed a positive impact on all-cause hospitalization (HR = 0.6; p = 0.027) and a trend for improved IPF-related mortality (HR = 0.5; p = 0.076).
Conclusion:
This retrospective post-hoc analysis suggests a potential benefit of statins on relevant clinical outcomes in IPF. However, these findings need validation in prospective clinical trials.