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Intérêt des statines dans le traitement de fond de la BPCO

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All cause mortalityMancini 2006 – high CV risk RR 0,50 [0,40 – 0,62]Mancini 2006 – low CV risk RR 0,53 [0,44 – 0,64]Soyseth 2007 HR 0,57 [0,38 – 0,87]Keddissi 2007* OR 0,99 [0,51 – 1,94]Van Gestel 2008** HR 0,67 [0,52 – 0,86]

COPD mortalityFrost 2007 – cohort study OR 0,29 [0,16 – 0,52]Frost 2007 – case-control study OR 0,19 [0,08 – 0,47]

COPD hospitalizationsMancini 2006 – high CV risk RR 0,72 [0,56 – 0,92]Mancini 2006 – low CV risk RR 0,74 [0,67 – 0,82]

COPD exacerbationsBlamoun 2008 OR 0,43 [0,18 – 0,99]

Intubations for COPDBlamoun 2008 OR 0,10 [0,03 – 0,36]

Decline in lung functionKeddissi 2007 – FEV1 OR 0,27 [0,12 – 0,58]Keddissi 2007 – FVC OR 0,52 [0,34 – 0,80]

Myocardial infarctionMancini 2006 – high CV risk RR 0,48 [0,39 – 0,58]Mancini 2006 – low CV risk RR 0,69 [0,48 – 1,00]

0,2 0,4 0,6 0,8 1 1,2 1,4Favours active treatment Favours control

Placebo Statin

No. of Exacerbations per Person-Yr

250

No

. of

Par

tici

pan

ts

200

150

100

50

0

0 0,10-1,50 0,51-3,00 3,01-4,50 4,51-6,00 6,01-7,50 ≥ 7,51

Total No.of Patients

Placebo

Placebo

P = 0,34 by long-rank test

Statin

447

1,0

0,9

0,8

0,7

0,6

0,5

0,4

0,3

0,2

0,1

0,00 100 200 300 400 500 600 700 800 900 1000 1100 1200

292 (65,3)Statin

Follow-up (days)

Pro

po

rtio

n o

f P

atie

nts

wit

ho

ut

Exa

cerb

atio

n

430 293 (68,1)

Patients with TreatmentFailure (no./%)