RESUMO
BACKGROUND: The immune modulating properties of statins may benefit smokers with asthma. We tested the hypothesis that short-term treatment with atorvastatin improves lung function or indices of asthma control in smokers with asthma. METHODS: Seventy one smokers with mild to moderate asthma were recruited to a randomized double-blind parallel group trial comparing treatment with atorvastatin (40 mg per day) versus placebo for 4 weeks. After 4 weeks treatment inhaled beclometasone (400 µg per day) was added to both treatment arms for a further 4 weeks. The primary outcome was morning peak expiratory flow after 4 weeks treatment. Secondary outcome measures included indices of asthma control and airway inflammation. RESULTS: At 4 weeks, there was no improvement in the atorvastatin group compared to the placebo group in morning peak expiratory flow [-10.67 L/min, 95% CI -38.70 to 17.37, p = 0.449], but there was an improvement with atorvastatin in asthma quality of life score [0.52, 95% CI 0.17 to 0.87 p = 0.005]. There was no significant improvement with atorvastatin and inhaled beclometasone compared to inhaled beclometasone alone in outcome measures at 8 weeks. CONCLUSIONS: Short-term treatment with atorvastatin does not alter lung function but may improve asthma quality of life in smokers with mild to moderate asthma. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT00463827.
Assuntos
Antiasmáticos/administração & dosagem , Asma/tratamento farmacológico , Ácidos Heptanoicos/administração & dosagem , Pirróis/administração & dosagem , Fumar , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Asma/fisiopatologia , Atorvastatina , Beclometasona/uso terapêutico , Método Duplo-Cego , Esquema de Medicação , Quimioterapia Combinada , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Pico do Fluxo Expiratório , Qualidade de Vida , Inquéritos e Questionários , Resultado do TratamentoRESUMO
The high prevalence of cigarette smoking in patients with respiratory disease puts them at risk of developing clinically important drug interactions. Cigarette smoking reduces the therapeutic response to certain drugs such as theophyllines through the induction of hepatic cytochrome P450 isoenzymes. Smokers with asthma and patients with COPD have reduced sensitivity to corticosteroids, possibly due to non-eosinophilic airway inflammation, altered glucocorticoid receptor activity or reduced histone deacetylase activity. Although all smokers should be encouraged to stop smoking, there is limited information on the influence of smoking cessation on the therapeutic and anti-inflammatory effects of a number of the drugs used in the treatment of respiratory disease.