Extract
The main goal of management for COPD is to minimise symptoms and prevent exacerbations [1]. For patients with COPD, exacerbations are a major determinant of reduced quality of life, progressive decline in lung function and increased mortality, particularly from cardiovascular causes [1, 2]. Risk factors predicting future exacerbations include a prior exacerbation, increasing age, worsening lung function, current smoking, low body mass index and presence of comorbid diseases [3]. In addition, biomarkers of systemic inflammation (primarily mediated by interleukin (IL)-6), have been independently linked to increasing risk of COPD exacerbations in prospective studies [4, 5]. It is through this mechanism that statins (HMGCoA-reductase inhibitor) may benefit some patients with COPD (figure 1). Exacerbations of COPD are costly to treat, making up a large proportion of the costs of care for COPD [6]. Current therapies aimed at reducing COPD exacerbations are based primarily on long-acting inhaled bronchodilators and inhaled corticosteroids [7], where a 20–30% reduction is achieved relative to placebo [8].
Abstract
COPD exacerbations are associated with considerable morbidity and mortality. In a well-designed RCT, Schenk and colleagues show that simvastatin reduces COPD exacerbations by 23% relative to placebo in patients optimised on preventive inhaler therapy. https://bit.ly/2NAFM2v
Footnotes
Conflict of interest: R.P. Young has received consultancy fees from Synergenz BioScience Ltd and speaker honoraria from GSK and AstraZeneca; has patents related to SNPs for COPD and lung cancer risk are pending to Synergenz BioScience Ltd; and is a stockholder of Syngernz BioScience Ltd.
Conflict of interest: R.J. Scott has nothing to disclose.
- Received February 3, 2021.
- Accepted February 12, 2021.
- Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org