Statins may reduce risk of lung cancer among patients of idiopathic pulmonary fibrosis

KOREA: According to research findings presented at the American College of Chest Physicians (CHEST) 2022 Annual Meeting, conducted on October 16–19 in Nashville, Tennessee, statin therapy for more than 30 days following an IPF diagnosis has a protective effect on lung cancer. The study findings were published in CHEST Journal.

Investigators have been examining the pathogenesis of IPF and looking for a therapeutic method to treat it during the past few decades. IPF has been linked to pulmonary inflammatory injury, according to some research, although the disease's precise etiology and pathology are still unknown, and there is currently no proven effective treatment other than lung transplantation. Emerging basic research and clinical studies have demonstrated that statins, the conventional lipid-lowering medications, have potent antifibrotic actions that can slow the progression of IPF and pulmonary function deterioration.

The authors employed clinical data warehouse (CDW) for EMR-based clinical research to further explore the potential preventative implications of statins on lung cancer development in IPF patients.

Data from 2892 patients with IPF from a single center between 2009 and 2018 were included in the retrospective review. 126 people in the cohort had lung cancer. International classifications of diseases, 9th revision, served as the foundation for the diagnosis of IPF (ICD-9). In order to find several explanatory variables, including smoking histories, Cox proportional hazards analysis was performed.

Key highlights of the study:

• In individuals with IPF who did not take statins compared to those who did (P<.001), the cumulative incidence of lung cancer was higher.
• Patients with IPF with lung cancer had higher percentages of men (85.7% vs 66.4%, P<.001), patients taking statins for more than 30 days after IPF diagnosis (38.1% vs 21.7%, P<.001), current smokers (22.2% vs 9.3%, P<.001), and former smokers (34.1% vs 11.1%, P<.001).
• Patients with IPF were more likely to develop lung cancer if they used statins for more than 30 days after their diagnosis (hazard ratio [HR], 0.58; 95% CI, 0.37-0.92; P<.05), were men (HR, 2.20; 95% CI, 1.29-3.76; P<.01), were former smokers (HR, 2.46; 95% CI, 1.58-3.83; P<.001), or were current smokers (HR,2.33; 95% CI, 1.2-3.83; P <.001).
• Following an IPF diagnosis, statin use was linked to a higher overall survival (327.8 vs. 114.2 days, P =.02).
• Lung cancer mortality in patients with IPF was linked with statin use for more than 30 days (HR, 0.58; 95% CI, 0.36-0.94; P<.05) and male sex (HR, 0.47; 95% CI, 0.23-0.95; P<.05).

The authors came to the conclusion that taking statins for more than 30 days after being diagnosed with IPF prevented the development of lung cancer.

More prospective studies are required to confirm, they stated, "but based on this investigation, we can consider that frequent statin treatment has a function to minimize the risk of lung cancer development and related death in IPF patients."

REFERENCE

Lee YJ, Kang HS, Hong Y, et al. The effects of statin use on lung cancer development in patients with idiopathic pulmonary fibrosis using a clinical data warehouse. Presented at: CHEST 2022 Annual Meeting; October 16 to 19, 2022; Nashville, TN.