Authors: McAuley DF et al., N Engl J Med 2014 Sep 30;
Another randomized study showed no benefit for ventilator-free days or 28-day mortality in patients with acute respiratory distress syndrome.
Despite promising findings in observational studies, results of a large randomized, controlled trial recently demonstrated no benefit of statins in patients with acute respiratory distress syndrome (ARDS) secondary to sepsis (NEJM JW Gen Med May 29 2014). Whether ARDS from other causes might be amenable to statin treatment is unknown.
Investigators from the U.K. and Ireland randomized 540 patients with ARDS to receive either daily simvastatin (80 mg) or placebo. In more than half of patients, ARDS was caused by pneumonia; 41% of enrolled patients had sepsis. At 28 days, researchers found no difference between the groups in ventilator-free days, hospital length of stay, or mortality. More adverse events (e.g., elevated creatine kinase levels) occurred in simvastatin-treated patients.
Comment
This second large trial should close the door on further investigations focused using statins to treat ARDS patients. These results confirm the need to test hypotheses generated from observational studies with rigorous randomized trials.
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