Effects of short-term treatment with atorvastatin in smokers with asthma - a randomized controlled trial

Georgina Braganza,Suzanne M Lloyd,Lisa Jolly,Neil C Thomson,Charles Mcsharry,Iona Donnelly,Christopher J Weir,Jane Lafferty,Rekha Chaudhuri,Mark Spears,Frances Mair

doi:10.1186/1471-2466-11-16

Georgina Braganza, Suzanne M Lloyd + Show 9 more

Open Access

https://doi.org/10.1186/1471-2466-11-16

Copy DOI

Abstract

BackgroundThe immune modulating properties of statins may benefit smokers with asthma. We tested the hypothesis that short-term treatment with atorvastatin improves lung function or indices of asthma control in smokers with asthma.MethodsSeventy one smokers with mild to moderate asthma were recruited to a randomized double-blind parallel group trial comparing treatment with atorvastatin (40 mg per day) versus placebo for 4 weeks. After 4 weeks treatment inhaled beclometasone (400 μg per day) was added to both treatment arms for a further 4 weeks. The primary outcome was morning peak expiratory flow after 4 weeks treatment. Secondary outcome measures included indices of asthma control and airway inflammation.ResultsAt 4 weeks, there was no improvement in the atorvastatin group compared to the placebo group in morning peak expiratory flow [-10.67 L/min, 95% CI -38.70 to 17.37, p = 0.449], but there was an improvement with atorvastatin in asthma quality of life score [0.52, 95% CI 0.17 to 0.87 p = 0.005]. There was no significant improvement with atorvastatin and inhaled beclometasone compared to inhaled beclometasone alone in outcome measures at 8 weeks.ConclusionsShort-term treatment with atorvastatin does not alter lung function but may improve asthma quality of life in smokers with mild to moderate asthma.Trial RegistrationClinicaltrials.gov identifier: NCT00463827

Highlights

The immune modulating properties of statins may benefit smokers with asthma
This study aimed to test the hypothesis that short term treatment with atorvastatin, either alone or in addition to low dose inhaled corticosteroid improves lung function or other indices of asthma control and/or airway inflammation in smokers with asthma
N (%) Total IgE (IU/ml) Use of inhaled corticosteroid at screening, n (%) Equivalent beclometasone dose at screening, μg Use of long-acting bronchodilator (LABA) at screening, n (%) Pre-bronchodilator forced expiratory volume in one second (FEV1) % predicted FEV1 % reversibility Serum cotinine

Summary

Introduction

The immune modulating properties of statins may benefit smokers with asthma. We tested the hypothesis that short-term treatment with atorvastatin improves lung function or indices of asthma control in smokers with asthma. Retrospective or case cohort studies have shown statin use is associated with a reduced decline in lung function in cigarette smokers [18] and reduced exacerbation rates, hospital admission and mortality in patients with COPD[19]. Taken together, this evidence suggests that statin treatment may improve asthma control in smokers with asthma. This study aimed to test the hypothesis that short term treatment with atorvastatin, either alone or in addition to low dose inhaled corticosteroid improves lung function or other indices of asthma control and/or airway inflammation in smokers with asthma. Atorvastatin was chosen because of its favourable in vitro and in vivo anti-inflammatory properties [20,21,22] and evidence of clinical benefit at the dose of 40 mg daily in rheumatoid arthritis [21]

Objectives

Methods

Results

Conclusion