Indah Juliana, Suradi, Ana Rima Setijadi
Departemen Pulmonologi dan Kedokteran Respirasi, Fakultas Kedokteran Universitas Sebelas Maret, RSUD Dr. Moewardi, Surakarta
Abstract
Background: Inflammation of COPD is persistent and progressive. Chronic inhalation of cigarette smoke causes the neutrophil infiltration into the airways, release cytokines, proinflammatory chemokines and proteases, especially MMP-9. Structural abnormalities lead to hyperinflation and a sign of obstruction, assessed value of FEV%. Simvastatin is expected to inhibit the inflammation of COPD. This study aimed to identify and analyze the effect of simvastatin on levels of serum MMP-9 and FEV% stable COPD.
Methods: The study design used quasi-experimental clinical trial, pre and post design in stable COPD patients in Dr. Moewardi Surakarta hospital, taken by using consecutive sampling on August to October 2015, given 1×20 mg simvastatin treatment and placebo for 4 weeks. Inflammation measured by levels of the enzyme MMP-9 serum, clinical assessment measured by FEV%. Analysis of normal distribution of data using a paired t test or independent sample t test and Wilcoxon signed rank test or the Mann-Whitney test if it is not normal.
Results: The subjects consisted of 33 men and one woman. Four patients discontinuous due to exacerbation (1), died (1), and are not obedient to take medication (2) for a total of 30 male patients. No significant difference in the age distribution, the degree of smoking, comorbidities, and grouping of COPD in both groups (p> 0.05) difference. Different of FEV1% between the simvastatin and placebo (-1.36 vs -1.31 + 7.77 + 7,82) was not significantly different (p = 0.852). Increased MMP-9 occurred in the simvastatin and placebo (587.69 ± 752.26 vs 143.41 ± 459.75) with p = 0.061.
Conclusion: Delivery of simvastatin 1×20 mg for 4 weeks in patients with COPD did not affect serum levels of MMP-9 and FEV%. (J Respir Indo. 2016; 36: 231-6)
Keywords: Simvastatin, MMP-9, FEV, COPD