Effect of HMG CoA reductase inhibitors on the development of chronic lung allograft dysfunction

Abstract

Lung transplant recipients (LRs) have a reduced median 5-year survival of approximately 55% primarily due to chronic lung allograft dysfunction (CLAD). Statins have anti-inflammatory and immunomodulatory effects that may facilitate CLAD prevention. This study sought to evaluate statin effect on CLAD development. Adult bilateralLRs from January 2004 to October 2013 were included. Statin group included recipients with early statin use and continued for minimum 6 months. Propensity score matching was performed for age, gender, and native lung disease to select matched nonstatin group. Competing risk approach was used to evaluate statin effect on CLAD development at 3 years while controlling for acute rejection and CMV pneumonitis. A total of 130 patients were included in each group. CLAD cumulative incidence at 3 years for statin and nonstatin groups was 20.6% (CI: 11.8%-33.5%) and 22.4%

Pharmacotherapy of chronic lung allograft dysfunction post lung transplantation

“…A recent retrospective propensity score matched analysis of 260 LTRs who received a statin (started within 3 months posttransplant, continued for at least 6 months) were compared to those who did not. At 3 years, statin use was not associated with a decreased risk of any CLAD subtype (sub‐distribution hazard ratio [SHR]: .93, 95% CI .55—1.59) but was associated with a decreased risk of death (SHR: .45, 95% CI .22—.90) 36 . This is in contrast to the findings of Li and Johnson et al.…”