A group of collaborating international researchers just released a review article entitled, “State of the art review: management of bronchiectasis in adults,” which provides a critical update on the management of bronchiectasis focusing on emerging evidence and recent randomized controlled trials.  The results of the review can be found in the latest edition of the European Respiratory Journal.

Background Terminology:

• Statins: commonly prescribed medication used to reduce patients’ cholesterol levels. A well-known statin on the market is Crestor.
• Randomized control trial: a clinical trial in which the patients are randomly distributed into groups which are either subjected to the experimental procedure (such as use of a drug) or which serve as controls (given a placebo).

One study that has uncovered emerging evidence of an innovative treatment option for bronchiectasis entitled, “Atorvastatin as a stable treatment in bronchiectasis: a randomized controlled trial” was published in 2014 in The Lancet.  It tested whether atorvastatin, a statin, could reduce cough in patients with bronchiectasis.

About the Study:

The study recruited 60 patients aged 18-79 between June 23, 2011, and Jan 30, 2011, from a care clinic in the UK.  They were divided into 2 groups of 30 in which:

• Group 1 received a high dose (80 mg) of atorvastatin
• Group 2 received a placebo (no drug)

The primary study question asked was whether there was a significant difference in reduction of coughing episodes among the patients studied, throughout the experimental timeline.  The reduction in cough was measured by the Leicester Cough Questionnaire (LCQ) score, with a lower score indicating a more severe cough (1·3 units is considered a clinically important difference).

The primary finding showed that there was a significant difference between the two groups in the measured cough reduction, with a mean LCQ score differed between groups, and a mean change of 1·5 units in patients allocated atorvastatin versus -0·7 units in those assigned placebo. Other findings included:

• 12 (40%) of the 30 patients in the atorvastatin group improved by 1·3 units or more on the LCQ compared with five (17%) of 30 in the placebo group.
• Ten (33%) patients assigned atorvastatin had an adverse event versus three (10%) allocated placebo.
• No serious adverse events were recorded.

In a press release about the results, Dr. Pallavi Mandal, Clinical Research Fellow, University of Edinburgh, and lead study author, said: “There are few effective treatments for bronchiectasis so these are encouraging findings. Larger studies are now needed to find out whether statins could be useful as a long-term treatment option for patients with this disease.”