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Transcript of COPD
Chronic sputum production
Many respiratory infections
Shortness of breath = Dyspnea
Trouble catching one's breath
"Simvastatin for the prevention of exacerbations in moderate-to-severe Chronic Obstructive Pulmonary Disease COPD"
Criner GJ and al. The New England journal of medicine, 2014; 370(23): 2201-10
A daily dose of 40 mg of Simvastatin didn’t affect exacerbation rates ofpatients with COPD
Presentation ENGLISH WFARM1370
written informed consent
- spirometric variables : FVC & FEV1 ( at 12, 24 and 36 months)
- disease-specific quality of life SGRQ
-general quality of life SF-36
every 3 months
- interim development of exacerbations
- study-drug adherence
patients from 45 sites of USA & Canada
40 to 80 years of age , with moderate-to-severe COPD
(ex)-smokers: 10 or more pack-years
At least one of the following criteria :
needed supplemental O2 for respiratory problems
taking glucocorticoids or AB
hospitalized for COPD exacerbation
with active liver disease, alcoholism or allergy
unable to take statins due to contraindications
: verapamil and amlopidine
Exclusion if diabetes or glycated Hb >6,5%
time, severity of exacerbations
number of acute CV events
quality of life
changes in spirometric variables
exacerbation rate person/year
Interim analysis, Stopping guidelines & Monitoring plan
every 6 months to
-follow-up :rates, study-drug adherence, safety and efficacy results.
March 2013 meeting
: no indication of a treatment effect
October 2013 meeting
: no change : the rates of exacerbations and the number of deaths :similar in the 2 groups
STATCOPE stopped for futility
Prevention of Cardiovascular disease + risk reduction (stroke + infarctus)
Causes or risk factor
Clinical Diagnosis & Assessment
the latter from the burning of biomass fuels
Current Treatment of COPD
Based on the patient's symptoms
Risk of exacerbations
Severity of the spirometric abnormality
Identification of comorbidities
Family history of COPD
FEV 1 / FVC < 0.70 = persistent airflow limitation and thus of COPD
Anti-inflammatory effects of Simvastatin
- Simvastatin: the most powerful inhibitor of
-The patients had moderate to severe airway obstruction
-No marker of systemic inflammation :serum CRP level
-Interaction with other drugs
nb: COPD is an inflammatory disease reflected in increased airway and circulating inflammatory markers.
Beta 2 - Agonists (oral +inhaler)
short or long action
Combination long action beta 2 agonists + corticosteroids
Phosphodiesterase- 4 inhibitors
Experimental studies on animals: effect on lung tissue
Beneficial effects of simvastatin are in part due to inhibition of the epithelial production of key mediators of neutrophil chemotaxis, inflammation, and airway remodeling
Effect of Simvastatin on the time of the first exacerbation
There's no difference on the time of the first exacerbation between the two groups
Previous retrospective study
positive effect of Simvastatin
patients with CV diseases
STATCOPE: prospective study
no patients with CV diseases
no effect of Simvastatin
1) - What is COPD?
- What is SIMVASTATIN?
- Why a study on this subject?
2) - Methods
3) Effect or not?
We thank you for your attention.