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02-04-2012 | General practice | Article

Statins may protect against pneumonia

Abstract

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MedWire News: Findings from a JUPITER trial subanalysis suggest that statin therapy may reduce the risk for pneumonia development in healthy adults.

"The absolute risk reduction observed in this primary prevention setting was small, and the effects on infection may be greater in other settings," say Victor Novack, from Soroka University Medical Center in Beer-Sheva, Israel, and co-authors.

The JUPITER (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) trial involved 17,802 healthy adults aged at least 50 years. They were randomly allocated to treatment with rosuvastatin 20 mg daily (n=8901) or placebo (n=8901).

During a median follow-up period of 1.9 years (maximum of 5.0 years), more placebo-treated participants developed pneumonia than rosuvastatin-treated participants.

Specifically, 257 participants in the placebo group and 214 in the rosuvastatin group developed pneumonia during treatment, equivalent to a 17% relative risk reduction with rosuvastatin versus placebo.

In a separate analysis looking only at cases of pneumonia that occurred before a cardiovascular event, rosuvastatin treatment was associated with a 19% relative risk reduction versus placebo.

The rosuvastatin treatment effect persisted after adjustment for age, gender, pneumonia recurrence, smoking status, lipid levels, and metabolic syndrome, note the authors.

They also remark that the pneumonia protection provided by rosuvastatin appears to be time-related, as the majority of pneumonia cases among rosuvastatin participants occurred during the first 2.0 years of follow up.

The number of non-pneumonia infections was similar in the rosuvastatin and placebo groups, at 3760 and 3828, respectively. This indicates that rosuvastatin therapy may not reduce the risk for all types of infections, say the authors.

Further analysis confirmed that rates of respiratory, gastrointestinal, urinary tract, viral, and systemic sepsis infections each occurred at a similar frequency in the rosuvastatin and placebo groups.

By contrast, rates of soft tissue, gynecologic, and fungal infections were nonsignificantly lower with rosuvastatin therapy than with placebo.

"Potential mechanisms that might support a protective effect of statins for infectious diseases include mild anti-inflammatory, antioxidant, immunomodulatory, anti-apoptotic, and endothelial protection," suggest Novack and co-authors.

They conclude: "These data provide support for ongoing studies such as the Statins for Acutely Injured Lungs from Sepsis (SAILS) trial and emphasize the need for basic investigators to continue exploring novel mechanisms by which statin therapy appears to reduce the incidence of clinical events."

The findings appear online in the Canadian Medical Association Journal.

By Lauretta Ihonor

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