Key Point

Statins appear to slow lung function decline in smokers and former smokers.

SALT LAKE CITY—Smoking cessation has traditionally been the only therapy shown to slow the progression of COPD and other inflammatory pulmonary diseases, but recent findings suggest a new treatment. The potentially anti-inflammatory and immunomodulatory activity of statins could protect against smoking-induced lung damage in both current and former smokers.¹

"Until now, no medication has been shown to slow smoking-induced lung damage," said Walid G. Younis, MD, of the University of Oklahoma Medical Center in Oklahoma City. "Our study is the first to show that statins may decrease the decline in lung function in smokers and former smokers, and therefore, prevent millions from developing debilitating diseases that could eventually lead to death." The results of Dr. Younis and colleagues’ study were presented at the 72nd Annual International Scientific Assembly of the American College of Chest Physicians.

The researchers compared the effects of statin use on the management of 182 current smokers and 303 former smokers (mean age, 66.1) seen at the Oklahoma City Veterans Hospital. Patients had at least two pulmonary function tests, with an average of 2.7 years between the first and the last test. A total of 319 patients were categorized as having obstructive lung disease, 99 patients as having restrictive lung disease, and 67 patients as having normal lung function. Statin use was observed in 238 patients (49%), while the remaining 247 patients served as the control group. Baseline FEV₁ and FVC were 57% and 77% of the percent predicted, respectively.

FEV₁ and FVC declined among statin users by 2.5% and 1.3%, respectively, whereas among controls, there was a 12.8% and 10.3% decline in FEV₁ and FVC, respectively. Regardless of lung disease type and continuation or cessation of smoking, the beneficial effect of statin use remained significant. In addition, there was a 35% decline in the rate of respiratory-related emergency department visits and hospitalizations in obstructive lung disease patients who used statins. The change in FVC correlated only with statin use, while the change in FEV₁ correlated only with the change in FVC.

"It is conceivable that long-term statin therapy could be used in smokers and former smokers to prevent and slow the progression of lung diseases," said Dr. Younis. "Even though statins may help with lung function, they have no effect on [protecting] a patient from the major smoking-related killer, which is lung cancer. Therefore, smokers should never lose their incentive to quit smoking."

The researchers noted that whether decreasing the rate of lung function decline or preventing emphysema could lead to a reduction of lung cancer is currently unknown. Dr. Younis and colleagues recommended that future prospective randomized trials examine the effect of statins on lung function.

Reference
1. Younis WG, Chbeir EA, Daher NN, et al. Statins protect smokers from lung disease. Presented at: annual meeting of the American College of Chest Physicians; October 25, 2006; Salt Lake City, Utah.

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