Chest
Special FeaturesStatins and Interstitial Lung Disease: A Systematic Review of the Literature and of Food and Drug Administration Adverse Event Reports
Section snippets
Literature Review
We performed a systematic literature search for articles published in English and French from 1987 to September 2007 using PubMed and the search terms “HMG-CoA reductase inhibitors” or “statins” in combination with the terms “drug-induced interstitial lung disease,” “pulmonary fibrosis,” “interstitial pneumonitis,” or “parenchymal lung disease.” Abstracts and relevant articles were retrieved and reviewed in detail. Selected citations from these articles were also examined. Given the paucity of
Statin-Induced Parenchymal Lung Damage
The literature search using PubMed yielded eight articles describing a total of 14 case reports of ILD in association with statin use (Table 1). Hill et al4 in 1995 first described possible statin-induced ILD in a 76-year-old woman accompanying a syndrome of dermatomyositis. The association of statin use with ILD in this report is problematic, however, because the patient had very high anti-nuclear antibody titers and tested positive for a human leukocyte antigen serotype DR3, a known associate
Definition of ILD
ILD, also known as diffuse parenchymal lung disease, comprises a diverse group of disorders that may share similar pathologic findings. They may have cellular infiltration, scarring, and/or architectural disruption of the pulmonary parenchyma involving alveolar lining cells, small and large airways, endothelial basement membranes, and occasionally the pleura.12
Drug-Induced ILD
The lungs are vulnerable targets for many drugs. More than 150 pharmacologic agents have been reported to cause adverse pulmonary
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- 1
Dr. Thompson has received grant/research support from Merck, Pfizer, AstraZeneca, and B. Braun; is a consultant for Astra-Zeneca and Merck; is on the Speaker's Bureau for Merck, Pfizer, Abbott, AstraZeneca, and ScheringPlough; and owns stock in Schering Plough, Merck, Illumina, and Zoll. He has other financial or occasional speaking honoraria from Merck, Pfizer, Abbott, AstraZeneca, ScheringPlough, and Reliant.
- 2
Dr. Karas is a consultant for Merck and Abbott, and has received honoraria from Merck and Abbott.
- 3
Dr. Alsheikh-Ali is recipient of a faculty development award from Pfizer and Tufts Medical Center.
- 4
Dr. Fernandez has no conflicts of interests to disclose.