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Life after STATCOPE.

DESPITE ITS LIMITATIONS, the study results are intriguing and in line with findings from other retrospective cohorts. How then can we reconcile the apparent benefits observed in retrospective studies with the lack of clinical effect seen in prospective trials, particularly the Simvastatin in the Prevention of COPD Exacerbation (STATCOPE) study? Could it be that both negative and positive studies are "correct"?

Prospective studies have thus far not been adequately powered for mortality as an endpoint. Perhaps the choice of the particular statin matters? While STATCOPE involved simvastatin, the majority of the cohort reported by Raymakers et al. received atorvastatin. Or perhaps the negative results of STATCOPE could be related to careful selection of study participants with a low burden of systemic inflammation.

This most recent study reinforces the idea that statins may play a beneficial role in COPD, but it isn't clear which patients to target for therapy. It is unlikely that the findings by Raymakers et al. will reverse recent recommendations by the American College of Chest Physicians and Canadian Thoracic Society against the use of statins for the purpose of prevention of COPD exacerbations, but the suggestion of survival advantage related to statins certainly may breathe new life into an enthusiasm greatly tempered by STATCOPE.

Or Kalchiem-Dekel, MD, and Robert M. Reed, MD, are at the pulmonary and critical care medicine division, University of Maryland, Baltimore. Neither editorialist had conflicts of interest (Chest. 2017;152:456-7. doi: 10.1016/j. chest.2017.04.156).

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Title Annotation:VIEW ON THE NEWS
Author:Kalchiem-Dekel, Or; Reed, Robert M.
Publication:Internal Medicine News
Date:Oct 15, 2017
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