Effect of Atorvastatin on COPD Exacerbations

Non-commercial Clinical Trial of Statins CAncer Preventive and Pleiotropic TherApy IN Smokers With Chronic Obstructive Pulmonary Disease (COPD)

This study is testing if atorvastatin, a cholesterol-lowering medication, can help reduce flare-ups and inflammation in people with COPD.

Quick facts

• Phase: Phase 4
• Study type: Interventional
• Enrollment: 460 (estimated)
• Ages: 40 Years to 99 Years
• Sex: All
• Sponsor: Medical University of Bialystok (Academic / other)
• Locations: 1 site (Bialystok)
• Trial ID: NCT04789057 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the effectiveness of atorvastatin, a medication commonly used to lower cholesterol, in reducing inflammation and exacerbations in patients with chronic obstructive pulmonary disease (COPD). Conducted in Poland, the study involves a randomized, double-blind, placebo-controlled design with participants receiving either atorvastatin or a placebo over a period of 52 weeks. Patients will undergo multiple clinical assessments and blood tests to monitor their health and identify potential biomarkers for personalized treatment. The trial aims to improve understanding of how atorvastatin can benefit COPD patients and tailor treatments based on individual responses.

Who should consider this trial

Good fit: Ideal candidates are adults aged 40 and older with stable COPD and a history of moderate to severe exacerbations.

Not a fit: Patients with contraindications to statin therapy or those with mild COPD may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved management of COPD and reduced frequency of exacerbations for patients.

How similar studies have performed: While atorvastatin has been studied in various contexts, this specific application for COPD is novel and has not been extensively tested.

Eligibility criteria

Inclusion Criteria:

1. Subject has signed Informed Consent Form and is able to understand the purpose and procedures required for the study and is willing to participate in the study.
2. Subject \[male or female\] is aged 40 years and older.
3. Subject is able to understand and comply with the protocol requirements and instructions and is likely to complete the study as planned.
4. Patients with stable COPD with persistent airflow limitation (stable COPD (post-bronchodilator FEV1\<80% of the predicted normal and post-bronchodilator FEV1/FVC\<0,70 at visit 1.) Stage II- IV) and with moderate to very severe airflow limitation according to GOLD guidelines.
5. At least two moderate/severe COPD exacerbations, or at least one leading to hospitalization or ICU admission within 12 months, preceding screening visit.
6. Current or ex-smokers who have a smoking history of at least 10 pack years.

Exclusion Criteria:

1. Contraindication to statin therapy included but not limited to: known poliomyelitis, motor neuron disease, cranial or temporal arteritis, stroke or myopathy.
2. Statin use within the last 3 months prior to study start.
3. Prior diagnosis of statin induced myopathy or hypersensitivity reaction to another HMG-CoA-reductase inhibitor.
4. Using e-cigarettes or I IQOS tobacco heating system.
5. Pregnant or nursing (lactating) women.
6. Women of child bearing potential, unless they are using effective method of contraception during dosing of study treatment.
7. Patient with a clinically significant abnormality at visit 1 in investigator opinion.
8. Patients with a clinically relevant laboratory abnormality at visit 1 in investigator opinion.
9. Patients with a history of malignancy of any organ system (including lung cancer).
10. Patients unable to perform acceptable spirometry and lung volumes procedures.
11. Patients who had a COPD exacerbations that required treatment with antibiotics and/or oral corticosteroids and/or hospitalization in the 6 weeks prior to visit 1.
12. Patients who have had a respiratory tract infection within 4 weeks prior to visit1.
13. Patients requiring oxygen therapy (\>15hr/day) on a daily basis for chronic hypoxemia.
14. Patients with a history of asthma or onset of symptoms prior to age 40 years
15. Patients with concomitant pulmonary disease (e.g. lung fibrosis, sarcoidosis, interstitial lung disease, pulmonary hypertension, tuberculosis).
16. Patients with primary bronchiectasis.
17. Patients with a diagnosis of α-1 antitrypsin deficiency (AATD).
18. Patients with pulmonary lobectomy or lung volume reduction surgery or lung transplantation.
19. Active abuse of drugs or alcohol, poor compliance anticipated.
20. Use concomitant medications that are known to interact with atorvastatin: warfarin and other coumarin (vitamin K antagonists) anticoagulants, cyclosporin, gemfibrozil or other non or selective nonsteroidal anti-inflammatory drugs, proton pump inhibitors (PPIs) used by last 6 months.
21. Patients participating in or planning to participate in the active phase of a supervised pulmonary rehabilitation program during the study.
22. Use of other investigational drugs within 30 days or 5 half-lives, whichever is longer, prior to screening visit.
23. Those unable in the opinion of the Investigator to comply fully with the study requirements.

Where this trial is running

Bialystok

• Medical University Hospital — Bialystok, Poland (Recruiting)

Study contacts

• Principal investigator: Robert Mróz, Prof. MD — Medical University of Bialystok
• Study coordinator: Robert Mróz, Prof. MD

Conditions Copd; COPD Exacerbation; Smoking; Gene Expression; Atorvastatin