Background Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease characterised by progressive airflow limitation. Statins have anti-inflammatory and immunomodulating properties that could alter inflammation of the airways. The objective of this study is to systematically evaluate the effectiveness of adjunct statin therapy in improving exercise tolerance and pulmonary function indices in patients with chronic obstructive pulmonary disease.
Search strategy and inclusion criteria A thorough search was done using Medline and PubMed, with limits set on studies involving humans in a randomised control trial in English that examined the effect of statins in COPD.
Study manoeuvres All the articles retrieved were appraised separately and independently by two reviewers for its applicability, validity and the methodological quality of the randomised control trials by assessing allocation, blinding, and if follow up rate was adequate. Disagreements between the reviewers were resolved by consensus.
Statistical analysis Data collected were analysed using Review Manager Version 5.2.
Results A total of two articles met the end criteria. Outcome shows improvement in exercise time (treadmill test) at 95% CI, with statistically significant benefit with mean difference of 335.18 [253.93, 416.43] favouring Pravastatin group. The studies show inconclusive results for Pravastatin in improving FEV1(%) with 95% CI with mean difference of 0.05 [-4.61, 4.7]. The outcome in total lung capacity shows inconclusive results but shows a trend toward benefit with 95% CI with mean difference of -0.08 [-0.46, 0.30]. Inspiratory capacity results at 95% CI with mean difference of 0.13 [-0.06, 0.32] showed an inconclusive outcome but has a trend toward benefit. Improvement in the Borg dyspnea score at 95% CI, showing statistically significant benefit with mean difference of -2.91 [-3.19, -2.63] favouring the Pravastatin group.
Conclusions Statins already have an established role in treating cardiovascular patients because of their cholesterol-lowering ability, but also have anti-inflammatory and immunomodulatory effects that are beneficial in airway inflammation in COPD. Statin administration to COPD patients showed amelioration in exercise tolerance, improvement in dyspnea scores and augmentation in pulmonary function indices. Thus, statins may be useful as adjunct to currently available therapies as well as improvement in lipid status.
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