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Can statin drugs confer infection protection? Large controlled studies say no

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Statins and prevention of infections: Systematic review and meta-analysis of data from large randomized placebo controlled trials
– Source: British Medical Journal (BMJ), Nov 29, 2011

By HL van den Hoek, EMW van de Garde, et al.

[Note: To read the full text of this article free, click HERE. Some observational reports have suggested that cholesterol-lowering drugs might prevent or fight infections such as pneumonia or sepsis (blood borne bacterial infection). However, the review of large placebo controlled studies of statin users reported below suggests no causal association between statins and infection risk.]

Objective: To evaluate whether the potential of statins to lower the risk of infections as published in observational studies is causal.

Systematic review and meta-analysis of randomized placebo controlled trials.

Data Sources: Medline, Embase, and the Cochrane Library.

Study Selection: Randomized placebo controlled trials of statins (up to 10 March 2011) enrolling a minimum of 100 participants, with follow-up for at least one year.

Data Extraction:
Infection or infection related death.

Results: The first study selection yielded 632 trials. After screening of the corresponding abstracts and full text papers, 11 trials totaling 30,947 participants were included. 4,655 of the participants (2,368 assigned to statins and 2,287 assigned to placebo) reported an infection during treatment.

Meta-analysis showed no effect of statins on the risk of infections (relative risk 1.00, 95% confidence interval 0.96 to 1.05) or on infection related deaths (0.97, 0.83 to 1.13). [Note: an RR of 1.0 respresents no difference in risk between statin and placebo groups. The RR of 0.97 for deaths indicates a statistically insignificant average 3% difference between the two groups.]

Conclusion: These findings do not support the hypothesis that statins reduce the risk of infections. Absence of any evidence for a beneficial effect in large placebo controlled trials reduces the likelihood of a causal effect as reported in observational studies.

Source: British Medical Journal (BMJ), Nov 29, 2011. By van den Hoek HL, Bos WJ, de Boer A, van de Garde EM. Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht University, Utrecht, Netherlands. [Email: e.van.de.garde@antoniusziekenhuis.nl]

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