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Review
. 2011 Nov 29:343:d7281.
doi: 10.1136/bmj.d7281.

Statins and prevention of infections: systematic review and meta-analysis of data from large randomised placebo controlled trials

Hester L van den Hoek  1 , Willem Jan W Bos, Anthonius de Boer, Ewoudt M W van de Garde
Affiliations
Review

Statins and prevention of infections: systematic review and meta-analysis of data from large randomised placebo controlled trials

Hester L van den Hoek et al. BMJ. .

Abstract

Objective: To evaluate whether the potential of statins to lower the risk of infections as published in observational studies is causal.

Design: Systematic review and meta-analysis of randomised placebo controlled trials.

Data sources: Medline, Embase, and the Cochrane Library.

Study selection: Randomised placebo controlled trials of statins (up to 10 March 2011) enrolling a minimum of 100 participants, with follow-up for at least one year.

Data extraction: Infection or infection related death.

Results: The first study selection yielded 632 trials. After screening of the corresponding abstracts and full text papers, 11 trials totalling 30 947 participants were included. 4655 of the participants (2368 assigned to statins and 2287 assigned to placebo) reported an infection during treatment. Meta-analysis showed no effect of statins on the risk of infections (relative risk 1.00, 95% confidence interval 0.96 to 1.05) or on infection related deaths (0.97, 0.83 to 1.13).

Conclusion: These findings do not support the hypothesis that statins reduce the risk of infections. Absence of any evidence for a beneficial effect in large placebo controlled trials reduces the likelihood of a causal effect as reported in observational studies.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any company for the submitted work; WB had relationships with AstraZeneca and Merck/Schering Plough, for participation in the AURORA (A Study to Evaluate the Use of Rosuvastatin in Subjects on Regular Hemodialysis: An Assessment of Survival and Cardiovascular Events) trial and the SHARP (Study of Heart and Renal Protection) trial, respectively, in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

Figures

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Fig 1 Flow of participants through review
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Fig 2 Meta-analysis of statin treatment and risk of infections in randomised controlled trials
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Fig 3 Meta-analysis of statins and risk of infection related mortality in randomised controlled trials
See this image and copyright information in PMC

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