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Association Between Statin Use and Exacerbation of Chronic Obstructive Pulmonary Disease Among Patients Receiving Corticosteroids

Authors Huang YJ, Kao S, Kao LT, Chian CF, Chung CH, Chien WC, Wang KY

Received 18 November 2020

Accepted for publication 25 January 2021

Published 5 March 2021 Volume 2021:16 Pages 591—602

DOI https://doi.org/10.2147/COPD.S292026

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Richard Russell


Yi-Jen Huang,1,2 Senyeong Kao,1,3 Li-Ting Kao,1,3– 5 Chih-Feng Chian,6 Chi-Hsiang Chung,3,7 Wu-Chien Chien,1,3,7,* Kwua-Yun Wang1,8,9,*

1Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan; 2Department of Nursing, University of Kang Ning, Taipei, Taiwan; 3School of Public Health, National Defense Medical Center, Taipei, Taiwan; 4Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan; 5School of Pharmacy, National Defense Medical Center, Taipei, Taiwan; 6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri‐Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 7Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 8School of Nursing, National Defense Medical Center, Taipei, Taiwan; 9Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan

*These authors contributed equally to this work

Correspondence: Wu-Chien Chien
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan, Republic of China
Tel +886-2-87923311, Ext. 19189
Fax +886-2-87927235
Email [email protected]
Kwua-Yun Wang
Graduate Institute of Life Sciences, National Defense Medical Center, 9314R, No. 161, Section 6, Min-Chuan East Road, Neihu District, Taipei City, 11490, Taiwan
Tel +886-2-87923100 ext.18766
Email [email protected]

Purpose: The role of statins as anti-inflammatory drugs in chronic obstructive pulmonary disease (COPD) is controversial. This study aimed to determine the efficacy of statins used with or without corticosteroids in COPD patients.
Patients and Methods: This was a retrospective cohort study and used the two million outpatients and inpatients in Taiwan’s Longitudinal Health Insurance Database covering 2000 to 2015. A total of 92,460 patients were identified in this study. We divided COPD patients into four groups by auditing each patient’s medication (statins used or not; corticosteroids used or not) and used Cox regression to analyze and compare the effects of statins in COPD patients with or without corticosteroids.
Results: In terms of all COPD patients, our findings were consistent with previous studies showing that statins decreased COPD-related hospitalization and mortality rates. However, the beneficial effects were only observed in younger patients or those not taking corticosteroids in further analysis. Statins significantly decreased hospitalization and mortality rates in the non-corticosteroids groups. The hazard ratios increased with age and were not statistically significant for patients > 70 years old. Statins did not significantly decrease ED visits, hospitalization, and mortality in corticosteroids groups.
Conclusion: Statins decreased hospitalization and mortality rates in COPD patients not taking corticosteroids but were not efficacious in patients on corticosteroids therapy. Furthermore, the beneficial effects of statins gradually decreased with patient age. Based on the findings, statins used in COPD patients may need to consider the patient age and corticosteroids used or not.

Keywords: COPD, exacerbation, statins, corticosteroids, mortality

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