Statin use and its implications on survival and disease progression in the European MultiPartner Idiopathic Pulmonary Fibrosis Registry (EMPIRE)

<bold>Background:</bold> Published data suggest an association of statin use with a lower incidence of idiopathic pulmonary fibrosis (IPF), and with improved prognosis in established IPF. <bold>Objectives:</bold> We aimed to evaluate these interactions in patients included in the European MultiPartner IPF Registry (EMPIRE). <bold>Methods:</bold> Demographics and clinical data, computed tomography features and lung function tests were enregistered at baseline and every six months during follow up. Analyses were separated for prevalent and incident IPF, when diagnosed within 6 months before inclusion. Overall survival (OS) was calculated using Kaplan–Meier estimates, annual forced vital capacity (FVC) decline by a random slope and intercept model. Adjustments were made for sex, age, baseline FVC, body-mass index and comorbidities. <bold>Results:</bold> Of 4593 patients enrolled (71% men, mean age 70 years), 1304 (28%) reported statin medication at baseline. Statins were associated with older age and more, especially cardiovascular comorbidities. Adjusted OS did not significantly differ by statin use (HR 0.98 (95%CI 0.84-1.14, p=0.79) in incident patients. In those not treated with antifibrotics, OS was longer in patients taking statins, but there was no such difference in those using antifibrotics. Adjusted annual FVC decline was significantly (p=0.011) lower in patients taking statins. In statin users, FVC decline was significantly smaller both in those with and without antifibrotic treatment (p=0.002). <bold>Conclusions:</bold> Although statin use did not show significant implications on OS, annual FVC decline in patients taking statins was lower regardless of their antifibrotic treatment status.