Clarity in the murky waters of statins and COPD lung attacks

The 5794 patient analysis of the Copenhagen lung study showing that statin use is associated with a reduced risk of COPD lung attacks (see page 33) is a much better paper as a result of an effective collaboration between the authors and reviewers (next stop, collaboration between the England and Scotland football teams). The manuscript arrived at Thorax at about the same time as the authors of the STRATCOPE study (NEJM 2014;370:2201–10) reported that simvastatin treatment had no effect on the number of COPD lung attacks in patients who had severe airways disease but no evidence of or risk factors for cardiovascular disease. The key remaining question, well-articulated in a Hot off the Breath (Thorax 2014;69:891–4), is whether this result is generalisable to the wider population of patients with COPD. The reviewers and authors saw an opportunity to answer this question so the latter rebooted their computer and got back to work. The revised analysis confirmed no benefit of statin treatment in the highly selected subgroup of patients with pure airways …