Friday, July 23, 2010

Dr. David Fedson: The Case For Using Statins In A Pandemic

 

 

# 4750

 

 

During a major influenza pandemic, millions of people could fall desperately ill during the first few months.  Pharmaceutical interventions – like vaccines – take months to produce and distribute, and antivirals are in short supply as well. 

 

What the world really needs is a cheap (preferably generic) medication that will help treat severe influenza cases.

 

Ideally it would be a shelf stable pill, one that is easy to dispense, has a low incidence of side effects, and can reduce influenza morbidity and mortality.

 

A tall order.    But perhaps not impossible to fill.

 

At least, that’s the hope of a number of scientists who are looking into whether statins, or corticosteroids (or a combination of the two), might prove effective in reducing some of the most serious flu symptoms.

 

Dr. David Fedson has long championed the idea that we should be investigating statins and other cheaper drugs that may help modulate the immune response.

 

Fedson is a former Professor of Medicine at the University of Virginia School of Medicine and was formerly Director of Medical Affairs, Aventis Pasteur MSD.

 

 

A couple of his papers on the subject include:

 

Pandemic Influenza: A Potential Role for Statins in Treatment and Prophylaxis

David S. Fedsona

 

New Approaches to Confronting an Imminent Influenza Pandemic

Dr. Fedson and Peter Dunnill, DSc,FREng

 

In 2007 we saw a study that seemed to support the idea, one that indicated that statins lowered the mortality rate of people with pneumonia.

 

Statin drugs lower respiratory death risk: study

Tue Apr 10, 2007 12:40pm EDT

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - People who use statin drugs are less likely to die of influenza and chronic bronchitis, according to a study that shows yet another unexpected benefit of the cholesterol-lowering medications.

 

And in 2008 this encouraging report made the headlines:

 

Statins may cut pneumonia death, blood clot risks

27 Oct 2008 20:00:13 GMT

Source: Reuters

By Will Dunham

WASHINGTON, Oct 27 (Reuters) - Cholesterol-fighting drugs known as statins reduced the risk of dying from pneumonia or developing dangerous blood clots in the legs, adding to a growing list of benefits from the popular drugs, two research groups said on Monday.

 

Of course, not all of the studies have been positive.

  

Last July there was a report that found no evidence of benefit among pneumonia patients (see Another Take On Statins And Pneumonia) taking statins.

 

But another study, presented in October of last year at the annual meeting of the IDSA, the Infectious Diseases Society of America, in Philadelphia suggested the opposite - that statins cut the mortality rate for seasonal flu by 50%.

 

Maryn McKenna writing for CIDRAP brought us the details.

 

Statins may help patients with severe seasonal flu

Maryn McKenna * Contributing Writer

Oct 29, 2009 (CIDRAP News) – Commonly available drugs that are sold in lower-cost generic versions improve the survival of patients hospitalized for seasonal influenza, researchers reported today, raising the possibility of a widely available treatment that could be used in a severe flu pandemic if other drugs are in short supply.

 

So while not all of these studies are in alignment, many of them do support the idea that statins may be of considerable value during a pandemic.

 

Which brings us to a guest editorial posted today on the Center For Biosecurity’s Clinicians’ Biosecurity Network website.  

 

I’ve just reproduced the opening paragraph.  By all means, you’ll want to follow the link to read it in its entirety.

 

An Alternative Approach to Pandemic Influenza That Clinicians Everywhere Could Use

By David S. Fedson, MD, July 23, 2010

The initial waves of the first influenza pandemic of the 21st Century have passed. Despite the best efforts of influenza scientists, health officials, and companies, more than 90% of the world’s people did not have timely access to affordable supplies of vaccines and antiviral agents. Instead, they had to rely on 19th Century public health “technologies.” They should have (and probably could have) had something better.1-5


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