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Erschienen in: Current Infectious Disease Reports 8/2017

21.06.2017 | Respiratory Infections (F Arnold, Section Editor)

The Use of Statins and Risk of Community-Acquired Pneumonia

verfasst von: Mohammed A. Batais, Abdur Rahman Khan, Aref A. Bin Abdulhak

Erschienen in: Current Infectious Disease Reports | Ausgabe 8/2017

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Abstract

Purpose of the Review

Community-acquired pneumonia (CAP) is still associated with a large burden and causes significant morbidity and mortality. Besides universal vaccination and antibiotic treatment, statins as adjunctive therapy may also have a beneficial role in the prevention and treatment of CAP. Our goal from this review is to discuss the epidemiology of CAP, and role of statins as adjunctive therapy in the development of CAP.

Recent Findings

Statins are lipid-lowering medications characterized by their ability to control hypercholesterolemia in addition to other pleiotropic effects that could explain their role in the pathogenesis of CAP. While most observational studies have shown that statins reduce risk of pneumonia in the general population, patients with diabetes, and recently in patients with myocardial infarction, no randomized controlled trial (RCT) to date has been conducted to assess the efficacy of statins to prevent development of CAP.

Summary

Given the paucity of robust randomized evidence to assess statin use and the development of CAP, and considering conflicting results of the observational studies, we are not in favor of initiation of statins for either the prevention or treatment of CAP.
Literatur
1.
Zurück zum Zitat Steel HC, et al. Overview of community-acquired pneumonia and the role of inflammatory mechanisms in the immunopathogenesis of severe pneumococcal disease. Mediat Inflamm. 2013;2013 Steel HC, et al. Overview of community-acquired pneumonia and the role of inflammatory mechanisms in the immunopathogenesis of severe pneumococcal disease. Mediat Inflamm. 2013;2013
2.
3.
Zurück zum Zitat Feldman C, Anderson R. Community-acquired pneumonia: still a major burden of disease. Curr Opin Crit Care. 2016;22(5):477–84.CrossRefPubMed Feldman C, Anderson R. Community-acquired pneumonia: still a major burden of disease. Curr Opin Crit Care. 2016;22(5):477–84.CrossRefPubMed
4.
Zurück zum Zitat Faverio P and Restrepo MI. Non-antibiotic therapies for CAP. European Respiratory Monograph 63: Community-Acquired Pneumonia, 2014. 63. Faverio P and Restrepo MI. Non-antibiotic therapies for CAP. European Respiratory Monograph 63: Community-Acquired Pneumonia, 2014. 63.
5.
Zurück zum Zitat Khan, A.R., et al., The role of statins in prevention and treatment of community acquired pneumonia: a systematic review and meta-analysis. PLoS One, 2013. 8(1): p. e52929. Khan, A.R., et al., The role of statins in prevention and treatment of community acquired pneumonia: a systematic review and meta-analysis. PLoS One, 2013. 8(1): p. e52929.
6.
Zurück zum Zitat Hou W, et al.. Effect of statin therapy on cardiovascular and renal outcomes in patients with chronic kidney disease: a systematic review and meta-analysis. European heart journal, 2013: p. eht065. Hou W, et al.. Effect of statin therapy on cardiovascular and renal outcomes in patients with chronic kidney disease: a systematic review and meta-analysis. European heart journal, 2013: p. eht065.
7.
Zurück zum Zitat Gutierrez J, et al. Statin therapy in the prevention of recurrent cardiovascular events: a sex-based meta-analysis. Arch Intern Med. 2012;172(12):909–19.CrossRefPubMed Gutierrez J, et al. Statin therapy in the prevention of recurrent cardiovascular events: a sex-based meta-analysis. Arch Intern Med. 2012;172(12):909–19.CrossRefPubMed
8.
Zurück zum Zitat GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013.Lancet 2015; 385: 117–71. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013.Lancet 2015; 385: 117–71.
10.
Zurück zum Zitat McLaughlin JM, et al. Clinical and economic burden of community-acquired pneumonia in the Veterans Health Administration, 2011: a retrospective cohort study. Infection. 2015;43(6):671–80.CrossRefPubMedPubMedCentral McLaughlin JM, et al. Clinical and economic burden of community-acquired pneumonia in the Veterans Health Administration, 2011: a retrospective cohort study. Infection. 2015;43(6):671–80.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Rozenbaum MH, et al. Incidence, direct costs and duration of hospitalization of patients hospitalized with community acquired pneumonia: a nationwide retrospective claims database analysis. Vaccine. 2015;33(28):3193–9.CrossRefPubMed Rozenbaum MH, et al. Incidence, direct costs and duration of hospitalization of patients hospitalized with community acquired pneumonia: a nationwide retrospective claims database analysis. Vaccine. 2015;33(28):3193–9.CrossRefPubMed
12.
Zurück zum Zitat • Quan TP, et al. Increasing burden of community-acquired pneumonia leading to hospitalisation, 1998–2014. Thorax. 2016;71(6):535–42. This is an important reference that showed rapid increasing of CAP hospitalizations since 2008 in one UK region (Oxfordshire). CrossRefPubMedPubMedCentral • Quan TP, et al. Increasing burden of community-acquired pneumonia leading to hospitalisation, 1998–2014. Thorax. 2016;71(6):535–42. This is an important reference that showed rapid increasing of CAP hospitalizations since 2008 in one UK region (Oxfordshire). CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Morimoto K, et al. The burden and etiology of community-onset pneumonia in the aging Japanese population: a multicenter prospective study. PLoS One. 2015;10(3):e0122247.CrossRefPubMedPubMedCentral Morimoto K, et al. The burden and etiology of community-onset pneumonia in the aging Japanese population: a multicenter prospective study. PLoS One. 2015;10(3):e0122247.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Feldman C, Anderson R. Community-acquired pneumonia: pathogenesis of acute cardiac events and potential adjunctive therapies. CHEST Journal. 2015;148(2):523–32.CrossRef Feldman C, Anderson R. Community-acquired pneumonia: pathogenesis of acute cardiac events and potential adjunctive therapies. CHEST Journal. 2015;148(2):523–32.CrossRef
16.
Zurück zum Zitat Statt S, et al. Statin-conferred enhanced cellular resistance against bacterial pore-forming toxins in airway epithelial cells. Am J Respir Cell Mol Biol. 2015;53(5):689–702.CrossRefPubMedPubMedCentral Statt S, et al. Statin-conferred enhanced cellular resistance against bacterial pore-forming toxins in airway epithelial cells. Am J Respir Cell Mol Biol. 2015;53(5):689–702.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat McDowell A, S, et al. Simvastatin is protective during Staphylococcus aureus pneumonia. Curr Pharm Biotechnol. 2011;12(9):1455–62. McDowell A, S, et al. Simvastatin is protective during Staphylococcus aureus pneumonia. Curr Pharm Biotechnol. 2011;12(9):1455–62.
18.
Zurück zum Zitat Shyamsundar M, et al. Simvastatin decreases lipopolysaccharide-induced pulmonary inflammation in healthy volunteers. Am J Respir Crit Care Med. 2009;179(12):1107–14.CrossRefPubMedPubMedCentral Shyamsundar M, et al. Simvastatin decreases lipopolysaccharide-induced pulmonary inflammation in healthy volunteers. Am J Respir Crit Care Med. 2009;179(12):1107–14.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Quinton T, et al. Lipid rafts are required in Gαi signaling downstream of the P2Y12 receptor during ADP-mediated platelet activation. J Thromb Haemost. 2005;3(5):1036–41.CrossRefPubMed Quinton T, et al. Lipid rafts are required in Gαi signaling downstream of the P2Y12 receptor during ADP-mediated platelet activation. J Thromb Haemost. 2005;3(5):1036–41.CrossRefPubMed
20.
Zurück zum Zitat Matarazzo S, et al. Cholesterol-lowering drugs inhibit lectin-like oxidized low-density lipoprotein-1 receptor function by membrane raft disruption. Mol Pharmacol. 2012;82(2):246–54.CrossRefPubMed Matarazzo S, et al. Cholesterol-lowering drugs inhibit lectin-like oxidized low-density lipoprotein-1 receptor function by membrane raft disruption. Mol Pharmacol. 2012;82(2):246–54.CrossRefPubMed
21.
Zurück zum Zitat Marwali MR, et al. Modulation of ADP-induced platelet activation by aspirin and pravastatin: role of lectin-like oxidized low-density lipoprotein receptor-1, nitric oxide, oxidative stress, and inside-out integrin signaling. J Pharmacol Exp Ther. 2007;322(3):1324–32.CrossRefPubMed Marwali MR, et al. Modulation of ADP-induced platelet activation by aspirin and pravastatin: role of lectin-like oxidized low-density lipoprotein receptor-1, nitric oxide, oxidative stress, and inside-out integrin signaling. J Pharmacol Exp Ther. 2007;322(3):1324–32.CrossRefPubMed
22.
Zurück zum Zitat Phillip Owens III,A, Mackman N. The antithrombotic effects of statins. Annu Rev Med. 2014;65:433–45.CrossRefPubMed Phillip Owens III,A, Mackman N. The antithrombotic effects of statins. Annu Rev Med. 2014;65:433–45.CrossRefPubMed
23.
Zurück zum Zitat Troeman D, et al. The immunomodulatory effects of statins in community-acquired pneumonia: a systematic review. J Infect. 2013;67(2):93–101.CrossRefPubMed Troeman D, et al. The immunomodulatory effects of statins in community-acquired pneumonia: a systematic review. J Infect. 2013;67(2):93–101.CrossRefPubMed
24.
25.
Zurück zum Zitat Erkkilä L, et al. Effect of simvastatin, an established lipid-lowering drug, on pulmonary chlamydia pneumoniae infection in mice. Antimicrob Agents Chemother. 2005;49(9):3959–62.CrossRefPubMedPubMedCentral Erkkilä L, et al. Effect of simvastatin, an established lipid-lowering drug, on pulmonary chlamydia pneumoniae infection in mice. Antimicrob Agents Chemother. 2005;49(9):3959–62.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat •• Lin C-F, et al. Statin use associated with a reduced risk of pneumonia requiring hospitalization in patients with myocardial infarction: a nested case-control study. BMC cardiovascular disorders. 2016;16(1):24. This is a very important reference that provided the first study to assess statins in patients with myocardial infarction. CrossRefPubMedPubMedCentral •• Lin C-F, et al. Statin use associated with a reduced risk of pneumonia requiring hospitalization in patients with myocardial infarction: a nested case-control study. BMC cardiovascular disorders. 2016;16(1):24. This is a very important reference that provided the first study to assess statins in patients with myocardial infarction. CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Vinogradova Y, Coupland C, Hippisley-Cox J. Risk of pneumonia in patients taking statins: population-based nested case-control study. Br J Gen Pract. 2011;61(592):e742–8.CrossRefPubMedPubMedCentral Vinogradova Y, Coupland C, Hippisley-Cox J. Risk of pneumonia in patients taking statins: population-based nested case-control study. Br J Gen Pract. 2011;61(592):e742–8.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Nohria A, et al. Statins inhibit Rho kinase activity in patients with atherosclerosis. Atherosclerosis. 2009;205(2):517–21.CrossRefPubMed Nohria A, et al. Statins inhibit Rho kinase activity in patients with atherosclerosis. Atherosclerosis. 2009;205(2):517–21.CrossRefPubMed
29.
Zurück zum Zitat Subramanian S, et al. High-dose atorvastatin reduces periodontal inflammation: a novel pleiotropic effect of statins. J Am Coll Cardiol. 2013;62(25):2382–91.CrossRefPubMed Subramanian S, et al. High-dose atorvastatin reduces periodontal inflammation: a novel pleiotropic effect of statins. J Am Coll Cardiol. 2013;62(25):2382–91.CrossRefPubMed
31.
Zurück zum Zitat Schlienger RG, et al. Statins and the risk of pneumonia: a population-based, nested case-control study. Pharmacother: J Hum Pharmacol Drug Ther. 2007;27(3):325–32.CrossRef Schlienger RG, et al. Statins and the risk of pneumonia: a population-based, nested case-control study. Pharmacother: J Hum Pharmacol Drug Ther. 2007;27(3):325–32.CrossRef
32.
Zurück zum Zitat Myles PR, et al. Risk of community-acquired pneumonia and the use of statins, ace inhibitors and gastric acid suppressants: a population-based case-control study. Pharmacoepidemiol Drug Saf. 2009;18(4):269–75.CrossRefPubMed Myles PR, et al. Risk of community-acquired pneumonia and the use of statins, ace inhibitors and gastric acid suppressants: a population-based case-control study. Pharmacoepidemiol Drug Saf. 2009;18(4):269–75.CrossRefPubMed
33.
Zurück zum Zitat Kwong JC, Li P, Redelmeier DA. Influenza morbidity and mortality in elderly patients receiving statins: a cohort study. PLoS One. 2009;4(11):e8087.CrossRefPubMedPubMedCentral Kwong JC, Li P, Redelmeier DA. Influenza morbidity and mortality in elderly patients receiving statins: a cohort study. PLoS One. 2009;4(11):e8087.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Vinogradova Y, Coupland C, Hippisley-Cox J. Risk of pneumonia in patients taking statins: population-based nested case-control study. Br J Gen Pract. 2011;61(592):e742–8.CrossRefPubMedPubMedCentral Vinogradova Y, Coupland C, Hippisley-Cox J. Risk of pneumonia in patients taking statins: population-based nested case-control study. Br J Gen Pract. 2011;61(592):e742–8.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Smeeth L, Douglas I, Hall AJ, Hubbard R, Evans S. Effect of statins on a wide range of health outcomes: a cohort study validated by comparison with randomized trials. Br J Clin Pharmacol. 2009;67(1):99–109.CrossRefPubMedPubMedCentral Smeeth L, Douglas I, Hall AJ, Hubbard R, Evans S. Effect of statins on a wide range of health outcomes: a cohort study validated by comparison with randomized trials. Br J Clin Pharmacol. 2009;67(1):99–109.CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Nielsen AG, et al. The impact of statin use on pneumonia risk and outcome: a combined population-based case-control and cohort study. Crit Care. 2012;16(4):R122.CrossRefPubMedPubMedCentral Nielsen AG, et al. The impact of statin use on pneumonia risk and outcome: a combined population-based case-control and cohort study. Crit Care. 2012;16(4):R122.CrossRefPubMedPubMedCentral
37.
38.
Zurück zum Zitat Novack V, et al. The effect of rosuvastatin on incident pneumonia: results from the JUPITER trial. Can Med Assoc J. 2012;184(7):E367–72.CrossRef Novack V, et al. The effect of rosuvastatin on incident pneumonia: results from the JUPITER trial. Can Med Assoc J. 2012;184(7):E367–72.CrossRef
39.
Zurück zum Zitat Härkänen M, et al. Patient-specific risk factors of adverse drug events in adult inpatients—evidence detected using the Global Trigger Tool method. J Clin Nurs. 2015;24(3–4):582–91.CrossRefPubMed Härkänen M, et al. Patient-specific risk factors of adverse drug events in adult inpatients—evidence detected using the Global Trigger Tool method. J Clin Nurs. 2015;24(3–4):582–91.CrossRefPubMed
40.
Zurück zum Zitat • Havers F, et al. Statin use and hospital length of stay among adults hospitalized with community-acquired pneumonia. Clinical Infectious Diseases. 2016;62(12):1471–8. This is an important reference that determined whether statin use was associated with improved outcomes among adults hospitalized with CAP, including those with severe pneumonia, by comparing hospital length of stay (LOS) and in-hospital mortality between statin users and non-users. CrossRefPubMed • Havers F, et al. Statin use and hospital length of stay among adults hospitalized with community-acquired pneumonia. Clinical Infectious Diseases. 2016;62(12):1471–8. This is an important reference that determined whether statin use was associated with improved outcomes among adults hospitalized with CAP, including those with severe pneumonia, by comparing hospital length of stay (LOS) and in-hospital mortality between statin users and non-users. CrossRefPubMed
41.
Zurück zum Zitat •• Viasus D, et al. The effect of simvastatin on inflammatory cytokines in community-acquired pneumonia: a randomised, double-blind, placebo-controlled trial. BMJ open. 2015;5(1):e006251. This randomized controlled trail is a very important reference that determines whether statin therapy given to hospitalized patients with CAP improves clinical outcomes and reduces the concentration of inflammatory cytokines. CrossRefPubMedPubMedCentral •• Viasus D, et al. The effect of simvastatin on inflammatory cytokines in community-acquired pneumonia: a randomised, double-blind, placebo-controlled trial. BMJ open. 2015;5(1):e006251. This randomized controlled trail is a very important reference that determines whether statin therapy given to hospitalized patients with CAP improves clinical outcomes and reduces the concentration of inflammatory cytokines. CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat Kwok CS, et al. Statins and associated risk of pneumonia: a systematic review and meta-analysis of observational studies. Eur J Clin Pharmacol. 2012;68(5):747–55.CrossRefPubMed Kwok CS, et al. Statins and associated risk of pneumonia: a systematic review and meta-analysis of observational studies. Eur J Clin Pharmacol. 2012;68(5):747–55.CrossRefPubMed
43.
Zurück zum Zitat Chopra V, et al. Is statin use associated with reduced mortality after pneumonia? A systematic review and meta-analysis. Am J Med. 2012;125(11):1111–23.CrossRefPubMed Chopra V, et al. Is statin use associated with reduced mortality after pneumonia? A systematic review and meta-analysis. Am J Med. 2012;125(11):1111–23.CrossRefPubMed
Metadaten
Titel
The Use of Statins and Risk of Community-Acquired Pneumonia
verfasst von
Mohammed A. Batais
Abdur Rahman Khan
Aref A. Bin Abdulhak
Publikationsdatum
21.06.2017
Verlag
Springer US
Erschienen in
Current Infectious Disease Reports / Ausgabe 8/2017
Print ISSN: 1523-3847
Elektronische ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-017-0581-x

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