Pneumologie 2017; 71(S 01): S1-S125
DOI: 10.1055/s-0037-1598498
Posterbegehung – Sektion Klinische Pneumologie
Interstitielle Lungenerkrankungen – Ulrich Costabel/Essen, Lars Hagmeyer/Solingen
Georg Thieme Verlag KG Stuttgart · New York

Impact of statins on lung function decline in idiopathic pulmonary fibrosis (IPF)

M Kreuter
1  Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg; Translational Lung Research Center (Tlrc) Heidelberg, Member of the German Center for Lung Research (Dzl)
,
F Bonella
2  Interstitial and Rare Lung Disease Unit, Ruhrlandklinik University Hospital, University Duisburg-Essen
,
TM Maher
3  Nihr Biological Research Unit, Royal Brompton Hospital
,
U Costabel
2  Interstitial and Rare Lung Disease Unit, Ruhrlandklinik University Hospital, University Duisburg-Essen
,
P Spagnolo
4  Medical University Clinic, Kanton Hospital Baselland and University of Basel
,
D Weycker
5  Policy Analysis Inc. (Pai), Minerva Health Economics Network, Ltd., Brookline
,
KU Kirchgaessler
6  F. Hoffmann-La Roche Ltd
,
M Kolb
7  Firestone Institute for Respiratory Health, Department of Medicine, Pathology & Molecular Medicine, Mcmaster University
› Author Affiliations
Further Information

Publication History

Publication Date:
23 February 2017 (online)

 

Background:

Previously published data suggest that statin use might attenuate pulmonary function decline in IPF while other reports discuss the potential of statins to increase susceptibility to interstitial lung diseases.

Aim:

To assess the clinical relevance of statins in IPF.

Methods:

Patients randomly assigned to placebo in 3 large, controlled trials of pirfenidone in IPF (CAPACITY 004 & 006, ASCEND) were categorized by statin use. Groups were analyzed for mortality, hospitalization, decrease in FVC and 6MWD and progression-free survival (FVC decrease ≥10%, 6MWD decrease ≥50 m, or death) in a post-hoc analysis.

Results:

Of a total of 624 patients, 276 (44%) were statin users and 348 (56%) non-users. Groups were similar with regards to age, sex and physiologic measures at baseline but differed in relevant comorbidities, mainly cardiovascular disease and its risk factors. In univariate analyses, FVC decrease ≥10% or death differed significantly between groups favoring statin use (HR = 0.7; p = 0.012), while for progression-free survival there was a trend in favor of statins (HR = 0.8; p = 0.074). A significantly greater proportion of patients in the non-statin users (54.9%) had a relative decline in FVC % predicted of ≥5% compared to the statin users (48.6%, p = 0.038), while there was no difference in mean FVC decline (p = 0.276). For statins, multivariate analyses showed a positive impact on all-cause hospitalization (HR = 0.6; p = 0.027) and a trend for improved IPF-related mortality (HR = 0.5; p = 0.076).

Conclusion:

This retrospective post-hoc analysis suggests a potential benefit of statins on relevant clinical outcomes in IPF. However, these findings need validation in prospective clinical trials.