Statins are increasingly being evaluated for their ability to modulate inflammation. But, two new studies suggest they don’t help in sepsis-associated acute respiratory distress syndrome (ARDS) or in preventing exacerbations of chronic obstructive pulmonary disease (COPD). In the first study, 745 patients with sepsis-associated ARDS were randomized to enteral rosuvastatin (Crestor) or placebo with the primary outcome being mortality by day 60. The study was stopped early when no difference was found in mortality between the study groups (28.5% with rosuvastatin and 24.9% with placebo, P = 0.21). There was also no difference with ventilator-free days, although rosuvastatin was associated with higher rates of renal and hepatic failure. The authors conclude that rosuvastatin did not improve clinical outcomes in patients with sepsis-associated ARDS (N Engl J Med 2014;370:2191-2200). In the second study in the same issue, 885 patients with COPD were randomized to simvastatin 40 mg per day or placebo with the primary outcome of annual exacerbations. There was no difference in the rate of exacerbations after 2 years (1.36 simvastatin vs 1.39 placebo, P = 0.54). Other outcomes were also similar, including days to first exacerbation and the number of nonfatal serious events. The authors conclude that simvastatin 40 mg per day did not affect either the rate or time to first COPD exacerbation (N Engl J Med 2014;370:2201-2210).
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