Statin use and its implications on survival and disease progression in the European MultiPartner idiopathic pulmonary...

While recent data imply an association of statin use with improved prognosis in idiopathic pulmonary fibrosis (IPF), older reports suggested an increased risk of interstitial lung diseases development. We investigated the association of statin medication with survival and disease progression in the European MultiPartner IPF Registry (EMPIRE).

Patients with at least one year of follow-up and documented statin and/or antifibrotic treatment status from registry inclusion on were selected. Overall- and event-free survival (OS/EFS) were assessed, EFS was defined as either decline in ≥10% predicted relative forced vital capacity (FVC), ≥15% in diffusion capacity for carbon monoxide (DLCO), IPF exacerbation, respiratory hospitalization, and all-cause death. Results were adjusted for sex, age, baseline FVC, antifibrotic treatment status, presence of cardiovascular disease including diabetes, and time since IPF diagnosis.

Of 2,669 patients selected, 739 (27.7%) reported statin use and had longer OS than non-users (HR 0.79 (95% CI 0.69-0.9, p < 0.001). Adjusted OS however did not differ by statin use vs. non-use (HR 0.90 (95% CI 0.78-1.04), p = 0.16). In exploratory subgroup analyses according to statin and antifibrotic treatment status, significant differences in unadjusted OS were observed in patients not receiving antifibrotics (statin present vs. absent, HR 0.64 (95% CI 0.5-0.81), p < 0.001)), but not after adjusting for covariates. There were no meaningful differences in EFS according to statin treatment with or without concurrent antifibrotics.

We did not observe significant associations of statin treatment with outcomes in IPF patients in the EMPIRE registry.