Atorvastatin as a stable treatment in bronchiectasis: a randomised controlled trial

Area of Science:

• Respiratory Medicine
• Clinical Pharmacology

Background:

• Bronchiectasis is a chronic lung disease characterized by cough, sputum, and recurrent infections, with neutrophilic airway inflammation being a key feature.
• Statins, known for their pleiotropic effects, are being investigated as potential anti-inflammatory treatments for bronchiectasis.

Purpose of the Study:

• To conduct a proof-of-concept randomized controlled trial to evaluate the efficacy of atorvastatin in reducing cough in patients with bronchiectasis.

Main Methods:

• A randomized controlled trial involving 60 patients (18-79 years) with clinically significant bronchiectasis, comparing high-dose atorvastatin (80 mg daily) with placebo for 6 months.
• The primary endpoint was the change in cough severity, measured by the Leicester Cough Questionnaire (LCQ) score, analyzed by intention-to-treat.

Main Results:

• Atorvastatin treatment resulted in a mean improvement of 1.5 units on the LCQ score compared to -0.7 units in the placebo group (mean difference 2.2, p=0.01).
• Significantly more patients in the atorvastatin group (40%) achieved a clinically important reduction in cough (≥1.3 units) versus the placebo group (17%, p=0.04).
• Adverse events were more frequent in the atorvastatin group (33%) than the placebo group (10%, p=0.02), though no serious adverse events were reported.

Conclusions:

• Six months of atorvastatin treatment demonstrated a significant improvement in cough quality of life for patients with bronchiectasis.
• Further multicenter studies are warranted to investigate the long-term effects of statin therapy on reducing exacerbations in bronchiectasis.