Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Keio Allergy Center, Keio University Hospital, Tokyo, Japan.
J Asthma. 2022 Apr;59(4):801-810. doi: 10.1080/02770903.2021.1879850. Epub 2021 Feb 16.
To assess the effects of statins on asthma by systematically reviewing and conducting a meta-analysis on all clinical studies, including randomized controlled trials (RCTs) and observational studies, that examined the effects of statins on asthma.
PubMed, EMBASE databases, and Cochrane reviews were searched to identify RCTs and observational studies, conducted through June 16, 2020, that assessed the effect of statins as a treatment for asthma. A meta-analysis was conducted using the following main outcomes: asthma control test (ACT), asthma control questionnaire (ACQ), pre- and post-bronchodilator forced expiratory volume in one second (FEV1), peak flow (PEF), and asthma exacerbation (asthma-related emergency department (ED) visits and hospitalization).
Our search revealed 11 RCTs and 8 observational studies that met the inclusion criteria. A meta-analysis demonstrated that statin treatment significantly improved ACT scores (mean difference: 1.61, < 0.001) and ACQ scores (mean difference: -0.38, < 0.001) compared to a placebo. Furthermore, statin treatment significantly reduced asthma-related ED visits (hazard ratio [HR], 95% confidence interval [CI], 0.83 [0.75-0.92], < 0.001, number needed to treat [NNT], 5.9). However, statin treatment did not improve pulmonary function (FEV1 and PEF).
Our results suggest that statins have the potential to improve asthma control and reduce asthma exacerbation without any improvement in pulmonary function.
Supplemental data for this article can be accessed at publisher's website.
通过系统综述和荟萃分析评估他汀类药物对哮喘的影响,纳入所有评估他汀类药物治疗哮喘效果的临床研究,包括随机对照试验(RCT)和观察性研究。
检索PubMed、EMBASE 数据库和 Cochrane 综述,纳入截至 2020 年 6 月 16 日评估他汀类药物治疗哮喘的 RCT 和观察性研究。采用荟萃分析评估以下主要结局:哮喘控制测试(ACT)、哮喘控制问卷(ACQ)、支气管扩张剂前后 1 秒用力呼气量(FEV1)、峰流速(PEF)和哮喘恶化(哮喘相关急诊就诊和住院)。
共纳入 11 项 RCT 和 8 项观察性研究。荟萃分析结果显示,与安慰剂相比,他汀类药物治疗可显著改善 ACT 评分(平均差:1.61, < 0.001)和 ACQ 评分(平均差:-0.38, < 0.001)。此外,他汀类药物治疗可显著减少哮喘相关急诊就诊(风险比 [HR],95%置信区间 [CI]:0.83 [0.75-0.92], < 0.001,需要治疗的人数 [NNT]:5.9)。但他汀类药物治疗并未改善肺功能(FEV1 和 PEF)。
我们的研究结果表明,他汀类药物可能改善哮喘控制并减少哮喘恶化,而对肺功能无任何改善。