Statins reduce odds of an asthma-related hospitalization or ER visit

Results of a new study presented at the 2009 Annual Meeting of the American Academy of Asthma, Allergy and Immunology (AAAAI) show dramatic reductions in emergency room (ER) visits and hospitalizations for asthma patients taking cholesterol-lowering statins in addition to common asthma treatments.

The study was jointly conducted by researchers from Medco Health Solutions, Inc. and Brigham and Women's Hospital, a teaching affiliate of Harvard Medical School.

In the first and largest investigation of statin effects on clinical outcomes in humans with asthma, researchers found that among adult patients on inhaled corticosteroids, those also taking statins reduced their odds of an asthma-related hospitalization or ER visit by 33 percent.

"The implications of this study are exciting because they point to the potential role statins could play in helping prevent the most serious asthma attacks that land patients in the hospital," said Dr. Robert Epstein, Medco's chief medical officer and one of the study authors. "There has been heightened interest in how the anti-inflammatory power of statins might benefit asthma patients and a number of animal studies have shown encouraging results. While the findings of this patient study should be considered preliminary and further clinical studies will be needed to draw any conclusions about care, they do show promise for the use of statins in asthma treatment. To that end, there are currently a number of prospective studies on this topic underway that could provide additional insights and direction."

There are half a million asthma-related hospitalizations and 217,000 ER visits each year. In the United States, hospital care costs for asthma reached $4.7 billion in 2007.

The study included 6,574 adult patients who were prescribed inhaled corticosteroid therapy for asthma in 2006 and had one or more asthma-related hospitalizations or ER visits in the previous 12 months. The study followed these patients over a one-year period and compared those using a statin in conjunction with their asthma therapy to those who were not taking a statin.

The findings suggest that statins have a substantial positive impact on controlling asthma. While the incidence of a recurrent hospitalization or ER visit was 29.4 percent for those patients on a corticosteroid but not on a statin, it dropped to 20.5 percent for those patients taking both a corticosteroid and a statin, nearly a one-third reduction in risk.

This is the first in a series of studies that Medco is planning on asthma treatments. Future studies will examine factors that may be impeding the effectiveness of asthma medications.

"Controlling asthma can present tremendous challenges to patients and their physicians," said Dr. Scott Weiss, one of the study researchers and a Professor at Harvard Medical School. "We've known that even when people are compliant with their medications they can still fall victim to serious asthma attacks. Through our research efforts we hope to uncover the answers to why some people respond well to treatment and others do not. Statins may improve a medication's effectiveness, while factors like genetics and vitamin D deficiency may be impacting the benefits of these medications as well."

Inflammation and Asthma Treatments

Asthma is a chronic respiratory disease caused by inflammation and swelling of the airways and constriction of the muscles of the bronchial passages. Currently, the recommended drug therapies for treating asthma include the long-term use of inhaled corticosteroids to reduce airway inflammation and mucus production.

Statins are medications used to lower cholesterol levels in the blood and to reduce the risk of heart attack and stroke, but also have known anti-inflammatory properties that may play a role in protecting patients against cardiovascular disease. These same anti-inflammatory effects have also been a subject of interest in the treatment of asthma although statins are currently not approved for use as an asthma medication. As many as 20 to 30 percent of adults with asthma are estimated to also have conditions, such as established cardiovascular disease or diabetes mellitus, for which statin therapy may be indicated.