Effect of Statins on Asthma Control in Smokers With Asthma

Despite several studies, which have shown that smokers with asthma have more severe symptoms, accelerated decline in lung function and diminished response to treatment with inhaled and oral corticosteroids, more than 25% of asthmatics continue to smoke. Smoking cessation advice is often ineffective.

Statins are used as cholesterol lowering agents, however, there is now also evidence that they have additional anti-inflammatory effects which may be useful in treatment of smokers with asthma.

This is a randomised placebo controlled double-blind parallel group study.

Following screening to assess suitability for the study, patients will be randomised to treatment with either Atorvastatin 40mg or placebo (blank tablet)for 8 weeks.

After 4 weeks of treatment, all patients will be commenced on a low dose inhaled corticosteroid for the remainder of the study to assess whether treatment with statins can overcome steroid resistance in smokers with asthma.

Inclusion criteria

• Diagnosis of asthma for more than 1 year
• Symptomatic asthma
• Smoker with greater than 5 pack year history
• On short acting bronchodilator only- although may have medication weaned if stable

Exclusion criteria

• Ex-smokers or non-smokers
• Patients already on statin therapy
• Unstable asthma
• Previous statin sensitivity or myopathy or myositis
• On any medications known to interact with statins

Note separate entry criteria for pilot study of COPD patients