Nagendran M, McAuley DF, Kruger PS, et al. Intensive Care Med. 2017; 43: 663-71.
Study Question: What are the potential benefits and harms of using statins in patients with ARDS?
Study Description: This patient-level systematic review and meta-analysis included non-crossover randomized clinical trials that compared statin therapy to placebo in adult patients with ARDS (defined by the American-European Consensus Conference criteria or the Berlin definition). The co-primary outcomes were 28-day ventilator-free days (VFD) and 28-day mortality. The primary safety outcome was serious adverse events (not defined). The review was prepared in accordance to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guideline.
Results: A total of 6 studies (1755 patients) were included in the study. No difference was found in VFD (MD 0.34 days, 95% CI −0.68-+1.36; no p-value provided), 28-day mortality (RR 1.03, 95% CI 0.86-1.23; no p-value provided), or serious adverse events (RR 1.14, 95% CI 0.84-1.53; no p-value provided) using a two-stage, fixed-effect analysis. Patients receiving statins had a higher incidence of non-serious adverse events (e.g., creatinine kinase or liver enzyme elevation) than patients receiving placebo (12.1% vs. 8.9%; p=0.015)
Conclusion(s): There does not appear to be a clinical benefit of statin therapy in patients with ARDS.
Perspective: Utilizing the pleotropic effects of statins has been the target of research for various uses in medicine. Although there have been a few observational studies that suggest a benefit of statin therapy in ARDS and sepsis, this meta-analysis suggests that statins do not have a role in ARDS therapy. Based on previous trials and this meta-analysis, it is not recommended to continue with further studies assessing the benefit of statin therapy in ARDS.