Evaluation of The Safety and Efficacy of Low Dose Atorvastatin in Bronchial Asthma
Keywords:
Asthma, Atorvastatin, Anti-inflammatory, Lung function, Statin
Abstract
Introduction: Statins are lipid lowering drugs with pleiotropic anti-inflammatory and immunomodulatory effects. We tested the hypothesis that short-term treatment with atorvastatin improves asthma control and airway inflammation in chronic asthma patients.
Materials and Methods: This is a Prospective, Open label, Randomized, Controlled, Crossover study conducted at Stanley Medical College Hospital for 10 weeks. 60 patients with Chronic Asthma of more than 2 years duration were recruited. The patients were randomized to receive atorvastatin 10 mg daily for 4 weeks separated by a 2-week washout period in a crossover fashion. Patients continued on their usual asthma drug treatment throughout the study. The effects of atorvastatin on absolute eosinophil count (AEC), C- reactive protein (CRP), Forced Expiratory Volume in 1 sec (FEV1) were analyzed.
Results: Data analysis revealed that no significant differences in forced expiratory volume in the first second (FEV1), absolute eosinophil count and C- reactive protein levels in both control and study groups.
Conclusion: Our study shows atorvastatin is not effective in the treatment of chronic asthma.
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References
1. Global strategy for asthma management and prevention [internet] 2010. [updated 2012, cited 2011 june 10]. Available at http://www.ginasthma.org.
2. Fraser RS, Pare PD. Asthma. In: Fraser RS, Pare PD, Neil Colman, Nestor L. Muller (eds.) Diagnosis of diseases of the chest. 4th ed. Philadelphia: W.B. Saunders; 2004. p2077.
3. Peter J. Barnes. Asthma. Anthony S. Fauci, Dennis L. Kasper, Dan L. Longo, Eugene Braunwald, Joseph Loscalzo, S.L. Hauser (eds.) Harrison’s: Principles of Internal Medicine.17th ed. New york: Mc Graw Hill; 2008. p1598 - 1599.
4. Tripathi KD. Drugs for bronchial asthma. Essentials of Medical Pharmacology. 6th ed. New Delhi: Jaypee publishers; 2008. p217 - 226.
5. Maron DJ, Fazio S, Linton MF. Current perspectives on statins. Cir¬culation. 2000; 101(2): 207- 213. [PubMed]
6. Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, MacFarlane PW. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med. 1995; 333(20): 1301- 1307. [PubMed]
7. Munford RS. Statins and the acute phase response. NEJM. 2001;344(26):2016 – 2018. [PubMed]
8. Albert MA, Danielson E, Rifai N, Ridker PM. Effect of statin therapy on C-reactive protein levels: the pravastatin inflammation /CRP evaluation (PRINCE): a randomized trial and cohort study. JAMA. 2001; 286 (1): 64 -70. [PubMed]
9. Ridker PM, Rifai N, Pfeffer MA, Sacks F, Braunwald E. Long-term effects of pravastatin on plasma concentration of C-reactive pro¬tein. Circulation. 1999; 100 (3): 230 -235. [PubMed]
10. Takemoto M, Liao JK. Pleiotropic effects of 3-hydroxy-3-methyl glutaryl co-enzyme A reductase inhibitors. Arterioscler ThrombVasc Biol. 2001; 21(11):1712 – 1719. [PubMed]
11. Kwak B, Mulhaupt F, Myit S, Mach F. Statins as a newly recognized type of immunomodulator. Nat Med. 2000; 6 (12): 1399 - 1402. [PubMed]
12. Sparrow CP, Burton CA, Hernandez M, Mundt S, Hassing H, Patel S ‘et al’. Simvastatin has anti-inflamma¬tory and antiatherosclerotic activities independent of plasma cho¬lesterol lowering. Arterioscler Thromb Vasc Biol. 2001; 21(1): 115-21. [PubMed]
13. Hothersall E, McSharry C, Thomson NC. Potential therapeutic role for statins in respiratory disease. Thorax. 2006; 61(8):729-734. [PubMed]
14. Jarjour NN, Calhoun WJ. Enhanced production of oxygen radicals in asthma. J Lab Clin Med. 1994; 123(1): 131-136. [PubMed]
15. Kim DY, Ryu SY, Lim JE, Lee YS, Ro JY. Anti-inflammatory mecha¬nism of simvastatin in mouse allergic asthma model. Eur J Phar¬macol 2007; 557(1):76 - 86. [PubMed]
16. McKay A, Leung BP, McInnes IB, Thomson NC, Liew FY. A novel anti-inflammatory role of simvastatin in a murine model of asthma. J Immunol 2004; 172(5): 2903-8. [PubMed]
17. Stanek EJ, Aubert RE, Xia F, Frueh FW, Sanders C, Weiss ST et al. Impact of statin therapy on asthma-related event costs in adult asthma patients. Value Health 2009;12(3):A121–A122. [PubMed]
18. Alexeeff SE, Litonjua AA, Sparrow D et al. Statin use reduces decline in lung function: VA Normative Aging Study. Am J RespirCrit Care Med. 2007; 176(8): 742 –747. [PubMed]
19. William W. Busse, Sameer K. Mathur. Biology of Asthma. In: Alfred P. Fishman (eds.). 4th ed. New York: Mc Graw Hill; 2008. p773-774. [PubMed]
20. Hothersall EJ, Chaudhuri R, McSharry C, Donnelly I, Lafferty J, Mc¬Mahon AD. Effects of atorvastatin added to inhaled corticoste¬roids on lung function and sputum cell counts in atopic asthma. Thorax. 2008; 63(12): 1070-5. [PubMed]
21. Menzies D, Nair A, Meldrum KT, Fleming D, Barnes M, Lipworth BJ. Simvastatin does not exhibit therapeutic anti-inflammatory ef¬fects in asthma. J Allergy Clin Immunol 2007; 119 (2): 328-35.
22. Braganza G, Chaudhuri R, McSharry C, Weir CJ, Donnelly I, Jolly L et al. Effects of short-term treatment with atorvastatin in smokers with asthma–a randomized controlled trial. BMC Pulm Med. 2011; 11:16. [PubMed]
23. Thomson NC, Chaudhuri R: Asthma in smokers: challenges and opportunities. Curr Opin Pulm Med. 2009; 15(1):39–45. [PubMed]
24. Maneechotesuwan K, Ekjiratrakul W, Kasetsinsombat K, Wongkajornsilp A, Barnes PJ: Statins enhance the anti-inflammatory effects of inhaled corticosteroids in asthmatic patients through increased induction of indoleamine 2, 3-dioxygenase. J Allergy ClinImmunol 2010; 126(4):754-762. [PubMed]
25. N’Guessan PD, Riediger F, Vardarova K, Scharf S, Eitel J, Opitz B et al. Statins Control Oxidized LDL Mediated Histone Modifications and Gene Expression in Cultured Human Endothelial Cells. Arterioscler ThrombVascBiol. 2009; 29(3):380-386. [PubMed]
26. Lavoie KL, Bacon SL, Labrecque M, Cartier A, Ditto B. Higher BMI is associated with worse asthma control and quality of life but not asthma severity. Respir Med 2006; 100(4):648–657. [PubMed]
27. Forno E, Lescher R. Decreased response to inhaled steroids in overweight and obese asthmatic children. J Allergy ClinImmunol. 2011; 127(3):741–749.
28. Zeki AA, Oldham J, Wilson M et al: Statin use and asthma control in patients with severe asthma. BMJ open. 2013; 3(8).
2. Fraser RS, Pare PD. Asthma. In: Fraser RS, Pare PD, Neil Colman, Nestor L. Muller (eds.) Diagnosis of diseases of the chest. 4th ed. Philadelphia: W.B. Saunders; 2004. p2077.
3. Peter J. Barnes. Asthma. Anthony S. Fauci, Dennis L. Kasper, Dan L. Longo, Eugene Braunwald, Joseph Loscalzo, S.L. Hauser (eds.) Harrison’s: Principles of Internal Medicine.17th ed. New york: Mc Graw Hill; 2008. p1598 - 1599.
4. Tripathi KD. Drugs for bronchial asthma. Essentials of Medical Pharmacology. 6th ed. New Delhi: Jaypee publishers; 2008. p217 - 226.
5. Maron DJ, Fazio S, Linton MF. Current perspectives on statins. Cir¬culation. 2000; 101(2): 207- 213. [PubMed]
6. Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, MacFarlane PW. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med. 1995; 333(20): 1301- 1307. [PubMed]
7. Munford RS. Statins and the acute phase response. NEJM. 2001;344(26):2016 – 2018. [PubMed]
8. Albert MA, Danielson E, Rifai N, Ridker PM. Effect of statin therapy on C-reactive protein levels: the pravastatin inflammation /CRP evaluation (PRINCE): a randomized trial and cohort study. JAMA. 2001; 286 (1): 64 -70. [PubMed]
9. Ridker PM, Rifai N, Pfeffer MA, Sacks F, Braunwald E. Long-term effects of pravastatin on plasma concentration of C-reactive pro¬tein. Circulation. 1999; 100 (3): 230 -235. [PubMed]
10. Takemoto M, Liao JK. Pleiotropic effects of 3-hydroxy-3-methyl glutaryl co-enzyme A reductase inhibitors. Arterioscler ThrombVasc Biol. 2001; 21(11):1712 – 1719. [PubMed]
11. Kwak B, Mulhaupt F, Myit S, Mach F. Statins as a newly recognized type of immunomodulator. Nat Med. 2000; 6 (12): 1399 - 1402. [PubMed]
12. Sparrow CP, Burton CA, Hernandez M, Mundt S, Hassing H, Patel S ‘et al’. Simvastatin has anti-inflamma¬tory and antiatherosclerotic activities independent of plasma cho¬lesterol lowering. Arterioscler Thromb Vasc Biol. 2001; 21(1): 115-21. [PubMed]
13. Hothersall E, McSharry C, Thomson NC. Potential therapeutic role for statins in respiratory disease. Thorax. 2006; 61(8):729-734. [PubMed]
14. Jarjour NN, Calhoun WJ. Enhanced production of oxygen radicals in asthma. J Lab Clin Med. 1994; 123(1): 131-136. [PubMed]
15. Kim DY, Ryu SY, Lim JE, Lee YS, Ro JY. Anti-inflammatory mecha¬nism of simvastatin in mouse allergic asthma model. Eur J Phar¬macol 2007; 557(1):76 - 86. [PubMed]
16. McKay A, Leung BP, McInnes IB, Thomson NC, Liew FY. A novel anti-inflammatory role of simvastatin in a murine model of asthma. J Immunol 2004; 172(5): 2903-8. [PubMed]
17. Stanek EJ, Aubert RE, Xia F, Frueh FW, Sanders C, Weiss ST et al. Impact of statin therapy on asthma-related event costs in adult asthma patients. Value Health 2009;12(3):A121–A122. [PubMed]
18. Alexeeff SE, Litonjua AA, Sparrow D et al. Statin use reduces decline in lung function: VA Normative Aging Study. Am J RespirCrit Care Med. 2007; 176(8): 742 –747. [PubMed]
19. William W. Busse, Sameer K. Mathur. Biology of Asthma. In: Alfred P. Fishman (eds.). 4th ed. New York: Mc Graw Hill; 2008. p773-774. [PubMed]
20. Hothersall EJ, Chaudhuri R, McSharry C, Donnelly I, Lafferty J, Mc¬Mahon AD. Effects of atorvastatin added to inhaled corticoste¬roids on lung function and sputum cell counts in atopic asthma. Thorax. 2008; 63(12): 1070-5. [PubMed]
21. Menzies D, Nair A, Meldrum KT, Fleming D, Barnes M, Lipworth BJ. Simvastatin does not exhibit therapeutic anti-inflammatory ef¬fects in asthma. J Allergy Clin Immunol 2007; 119 (2): 328-35.
22. Braganza G, Chaudhuri R, McSharry C, Weir CJ, Donnelly I, Jolly L et al. Effects of short-term treatment with atorvastatin in smokers with asthma–a randomized controlled trial. BMC Pulm Med. 2011; 11:16. [PubMed]
23. Thomson NC, Chaudhuri R: Asthma in smokers: challenges and opportunities. Curr Opin Pulm Med. 2009; 15(1):39–45. [PubMed]
24. Maneechotesuwan K, Ekjiratrakul W, Kasetsinsombat K, Wongkajornsilp A, Barnes PJ: Statins enhance the anti-inflammatory effects of inhaled corticosteroids in asthmatic patients through increased induction of indoleamine 2, 3-dioxygenase. J Allergy ClinImmunol 2010; 126(4):754-762. [PubMed]
25. N’Guessan PD, Riediger F, Vardarova K, Scharf S, Eitel J, Opitz B et al. Statins Control Oxidized LDL Mediated Histone Modifications and Gene Expression in Cultured Human Endothelial Cells. Arterioscler ThrombVascBiol. 2009; 29(3):380-386. [PubMed]
26. Lavoie KL, Bacon SL, Labrecque M, Cartier A, Ditto B. Higher BMI is associated with worse asthma control and quality of life but not asthma severity. Respir Med 2006; 100(4):648–657. [PubMed]
27. Forno E, Lescher R. Decreased response to inhaled steroids in overweight and obese asthmatic children. J Allergy ClinImmunol. 2011; 127(3):741–749.
28. Zeki AA, Oldham J, Wilson M et al: Statin use and asthma control in patients with severe asthma. BMJ open. 2013; 3(8).
CITATION
DOI: 10.17511/ijmrr.2014.i05.04
Published: 2014-10-31
How to Cite
1.
R G, Madhavan S, Parvathavarthini S. Evaluation of The Safety and Efficacy of Low Dose Atorvastatin in Bronchial Asthma. Int J Med Res Rev [Internet]. 2014Oct.31 [cited 2024Nov.23];2(5):420- 427. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/133
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Original Article
OAI - Open Archives Initiative
