Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
Department of Nursing, University of Kang Ning, Taipei, Taiwan.
Int J Chron Obstruct Pulmon Dis. 2021 Mar 5;16:591-602. doi: 10.2147/COPD.S292026. eCollection 2021.
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.
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.
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.
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.
他汀类药物作为抗炎药物在慢性阻塞性肺疾病（COPD）中的作用存在争议。本研究旨在确定他汀类药物与或不与皮质类固醇联合用于 COPD 患者的疗效。
这是一项回顾性队列研究，使用了台湾 2000 年至 2015 年的 200 万门诊和住院患者的纵向健康保险数据库。本研究共纳入 92460 例患者。我们通过审核每位患者的用药情况（使用或不使用他汀类药物；使用或不使用皮质类固醇）将 COPD 患者分为四组，并使用 Cox 回归分析和比较有或无皮质类固醇的 COPD 患者中他汀类药物的效果。
就所有 COPD 患者而言，我们的研究结果与之前的研究一致，表明他汀类药物降低了 COPD 相关住院率和死亡率。然而，进一步分析发现，这种有益作用仅在年轻患者或未使用皮质类固醇的患者中观察到。他汀类药物在未使用皮质类固醇的组中显著降低了住院和死亡率。随着年龄的增加，风险比增加，但对于 >70 岁的患者则无统计学意义。他汀类药物在皮质类固醇组中并未显著降低 ED 就诊、住院和死亡率。
他汀类药物降低了未使用皮质类固醇的 COPD 患者的住院率和死亡率，但在使用皮质类固醇治疗的患者中无效。此外，他汀类药物的有益作用随患者年龄的增加而逐渐降低。基于这些发现，在 COPD 患者中使用他汀类药物可能需要考虑患者的年龄和是否使用皮质类固醇。
