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Effect of statins on disease-related outcomes in patients with idiopathic pulmonary fibrosis

BACKGROUND: Data are conflicting regarding the possible effects of statins in patients with idiopathic pulmonary fibrosis (IPF). This post hoc analysis assessed the effects of statin therapy on disease-related outcomes in IPF. METHODS: Patients randomised to placebo (n=624) in three controlled trial...

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Autores principales: Kreuter, Michael, Bonella, Francesco, Maher, Toby M, Costabel, Ulrich, Spagnolo, Paolo, Weycker, Derek, Kirchgaessler, Klaus-Uwe, Kolb, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5284334/
https://www.ncbi.nlm.nih.gov/pubmed/27708114
http://dx.doi.org/10.1136/thoraxjnl-2016-208819
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author Kreuter, Michael
Bonella, Francesco
Maher, Toby M
Costabel, Ulrich
Spagnolo, Paolo
Weycker, Derek
Kirchgaessler, Klaus-Uwe
Kolb, Martin
author_facet Kreuter, Michael
Bonella, Francesco
Maher, Toby M
Costabel, Ulrich
Spagnolo, Paolo
Weycker, Derek
Kirchgaessler, Klaus-Uwe
Kolb, Martin
author_sort Kreuter, Michael
collection PubMed
description BACKGROUND: Data are conflicting regarding the possible effects of statins in patients with idiopathic pulmonary fibrosis (IPF). This post hoc analysis assessed the effects of statin therapy on disease-related outcomes in IPF. METHODS: Patients randomised to placebo (n=624) in three controlled trials of pirfenidone in IPF (CAPACITY 004 and 006, ASCEND) were categorised by baseline statin use. Outcomes assessed during the 1-year follow-up included disease progression, mortality, hospitalisation and composite outcomes of death or ≥10% absolute decline in FVC and death or ≥50 m decline in 6-minute walk distance (6MWD). RESULTS: At baseline, 276 (44%) patients were statin users versus 348 (56%) non-users. Baseline characteristics were similar between groups, except statin users were older and had higher prevalence of cardiovascular disease and risk factors. In multivariate analyses adjusting for differences in baseline characteristics, statin users had lower risks of death or 6MWD decline (HR 0.69; 95% CI 0.48 to 0.99, p=0.0465), all-cause hospitalisation (HR 0.58; 95% CI 0.35 to 0.94, p=0.0289), respiratory-related hospitalisation (HR 0.44; 95% CI 0.25 to 0.80, p=0.0063) and IPF-related mortality (HR 0.36; 95% CI 0.14 to 0.95, p=0.0393) versus non-users. Non-significant treatment effects favouring statin use were observed for disease progression (HR 0.75; 95% CI 0.52 to 1.07, p=0.1135), all-cause mortality (HR 0.54; 95% CI 0.24 to 1.21, p=0.1369) and death or FVC decline (HR 0.71; 95% CI 0.48 to 1.07, p=0.1032). CONCLUSIONS: This post hoc analysis supports the hypothesis that statins may have a beneficial effect on clinical outcomes in IPF. Prospective clinical trials are required to validate these observations. TRIAL REGISTRATION NUMBERS: NCT01366209, NCT00287729 and NCT00287716.
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spelling pubmed-52843342017-02-07 Effect of statins on disease-related outcomes in patients with idiopathic pulmonary fibrosis Kreuter, Michael Bonella, Francesco Maher, Toby M Costabel, Ulrich Spagnolo, Paolo Weycker, Derek Kirchgaessler, Klaus-Uwe Kolb, Martin Thorax Interstitial Lung Disease BACKGROUND: Data are conflicting regarding the possible effects of statins in patients with idiopathic pulmonary fibrosis (IPF). This post hoc analysis assessed the effects of statin therapy on disease-related outcomes in IPF. METHODS: Patients randomised to placebo (n=624) in three controlled trials of pirfenidone in IPF (CAPACITY 004 and 006, ASCEND) were categorised by baseline statin use. Outcomes assessed during the 1-year follow-up included disease progression, mortality, hospitalisation and composite outcomes of death or ≥10% absolute decline in FVC and death or ≥50 m decline in 6-minute walk distance (6MWD). RESULTS: At baseline, 276 (44%) patients were statin users versus 348 (56%) non-users. Baseline characteristics were similar between groups, except statin users were older and had higher prevalence of cardiovascular disease and risk factors. In multivariate analyses adjusting for differences in baseline characteristics, statin users had lower risks of death or 6MWD decline (HR 0.69; 95% CI 0.48 to 0.99, p=0.0465), all-cause hospitalisation (HR 0.58; 95% CI 0.35 to 0.94, p=0.0289), respiratory-related hospitalisation (HR 0.44; 95% CI 0.25 to 0.80, p=0.0063) and IPF-related mortality (HR 0.36; 95% CI 0.14 to 0.95, p=0.0393) versus non-users. Non-significant treatment effects favouring statin use were observed for disease progression (HR 0.75; 95% CI 0.52 to 1.07, p=0.1135), all-cause mortality (HR 0.54; 95% CI 0.24 to 1.21, p=0.1369) and death or FVC decline (HR 0.71; 95% CI 0.48 to 1.07, p=0.1032). CONCLUSIONS: This post hoc analysis supports the hypothesis that statins may have a beneficial effect on clinical outcomes in IPF. Prospective clinical trials are required to validate these observations. TRIAL REGISTRATION NUMBERS: NCT01366209, NCT00287729 and NCT00287716. BMJ Publishing Group 2017-02 2016-10-05 /pmc/articles/PMC5284334/ /pubmed/27708114 http://dx.doi.org/10.1136/thoraxjnl-2016-208819 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Interstitial Lung Disease
Kreuter, Michael
Bonella, Francesco
Maher, Toby M
Costabel, Ulrich
Spagnolo, Paolo
Weycker, Derek
Kirchgaessler, Klaus-Uwe
Kolb, Martin
Effect of statins on disease-related outcomes in patients with idiopathic pulmonary fibrosis
title Effect of statins on disease-related outcomes in patients with idiopathic pulmonary fibrosis
title_full Effect of statins on disease-related outcomes in patients with idiopathic pulmonary fibrosis
title_fullStr Effect of statins on disease-related outcomes in patients with idiopathic pulmonary fibrosis
title_full_unstemmed Effect of statins on disease-related outcomes in patients with idiopathic pulmonary fibrosis
title_short Effect of statins on disease-related outcomes in patients with idiopathic pulmonary fibrosis
title_sort effect of statins on disease-related outcomes in patients with idiopathic pulmonary fibrosis
topic Interstitial Lung Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5284334/
https://www.ncbi.nlm.nih.gov/pubmed/27708114
http://dx.doi.org/10.1136/thoraxjnl-2016-208819
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