The role of statins in prevention and treatment of community acquired pneumonia: a systematic review and meta-analysis.

Khan, A. R., Riaz, M. ORCID: https://orcid.org/0000-0002-5512-1745, Bin Abdulhak, A. A., Al-Tannir, M. A., Garbati, M. A., Erwin, P. J., Baddour, L. M. and Tleyjeh, I. M. 2013. The role of statins in prevention and treatment of community acquired pneumonia: a systematic review and meta-analysis. PLoS ONE 8 (1) , e52929.. 10.1371/journal.pone.0052929

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Abstract

Background Emerging epidemiological evidence suggests that statins may reduce the risk of community-acquired pneumonia (CAP) and its complications. Purpose Performed a systematic review to address the role of statins in the prevention or treatment of CAP. Data Source Ovid MEDLINE, Cochrane, EMBASE, ISI Web of Science, and Scopus from inception through December 2011 were searched for randomized clinical trials, cohort and case-control studies. Study Selection Two authors independently reviewed studies that examined the role of statins in CAP. Data Extraction Data about study characteristics, adjusted effect-estimates and quality characteristics was extracted. Data Synthesis Eighteen studies corresponding to 21 effect-estimates (eight and 13 of which addressed the preventive and therapeutic roles of statins, respectively) were included. All studies were of good methodological quality. Random-effects meta-analyses of adjusted effect-estimates were used. Statins were associated with a lower risk of CAP, 0.84 (95% CI, 0.74–0.95), I2 = 90.5% and a lower short-term mortality in patients with CAP, 0.68 (95% CI, 0.59–0.78), I2 = 75.7%. Meta-regression did not identify sources of heterogeneity. A funnel plot suggested publication bias in the treatment group, which was adjusted by a novel regression method with a resultant effect-estimate of 0.85 (95% CI, 0.77–0.93). Sensitivity analyses using the rule-out approach showed that it is unlikely that the results were due to an unmeasured confounder. Conclusions Our meta-analysis reveals a beneficial role of statins for the risk of development and mortality associated with CAP. However, the results constitute very low quality evidence as per the GRADE framework due to observational study design, heterogeneity and publication bias.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Centre for Trials Research (CNTRR) Medicine
Additional Information:	This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Publisher:	Public Library of Science
ISSN:	1932-6203
Date of First Compliant Deposit:	6 December 2021
Date of Acceptance:	22 November 2012
Last Modified:	15 May 2023 17:26
URI:	https://orca.cardiff.ac.uk/id/eprint/145901

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