# 6008
We’ve a study today that lends additional weight to the argument that statins – a class of cholesterol lowering drugs – may have a role to play in the treatment of influenza.
This would be of particular value during a severe pandemic, when the world would need a cheap (preferably generic) medication that is shelf stable, easy to dispense, has a low incidence of side effects, and can reduce influenza morbidity and mortality.
That’s a tall order, but there are some researchers who believe that statins might fit the bill.
Over the years we’ve seen a number of studies that have suggested that taking statins can improve survival rates among those with influenza and/or pneumonia.
The idea of using them in a pandemic has been largely championed by Dr. David Fedson – former Professor of Medicine at the University of Virginia School of Medicine and formerly Director of Medical Affairs, Aventis Pasteur MSD who has urged that scientists look seriously at statins, which he believes may help modulate the immune response.
A couple of his papers on the subject include:
Pandemic Influenza: A Potential Role for Statins in Treatment and Prophylaxis
David S. Fedson
New Approaches to Confronting an Imminent Influenza Pandemic
Dr. Fedson and Peter Dunnill, DSc,FREng
While we’ve seen a number of studies (see here, here, and here) supporting the notion that statins might reduce mortality due to pneumonia and/or influenza, not every study has been positive.
In July of 2009 there was a report that found no evidence of benefit among pneumonia patients (see Another Take On Statins And Pneumonia) taking statins.
Today, from the IDSA’s Journal of Infectious Disease we have a new study that looked at the 30 day survival rates of hospitalized influenza patients either taking, or not taking, statins.
They found, after adjusting for:
- age;
- race;
- cardiovascular, pulmonary, and renal disease;
- influenza vaccination and antiviral administration
Those not already on statins, or placed on statins during their hospital stay, were nearly twice as likely to die within 30 days of hospitalization as those who received statins.
A cautionary note: This was an observational study, not a Randomized Controlled Trial – and so there may have been confounding factors not adjusted for by the authors. Additionally, this study did not attempt to track the amount of statins used by patients during their hospitalization.
First a link to the study’s abstract, followed by a few excerpts to the press release, and then a link to an accompanying editorial.
Association Between Use of Statins and Mortality Among Patients Hospitalized With Laboratory-Confirmed Influenza Virus Infections: A Multistate Study
J Infect Dis. jir695 first published online December 13, 2011 doi:10.1093/infdis/jir695
Meredith L. Vandermeer, Ann R. Thomas, Laurie Kamimoto, Arthur Reingold, Ken Gershman, James Meek, Monica M. Farley, Patricia Ryan, Ruth Lynfield, Joan Baumbach, William Schaffner, Nancy Bennett and Shelley Zansky
Since the bulk of this study is behind a pay wall, the press release from the IDSA provides some valuable details.
Infectious Diseases Society of America
Statins may reduce mortality in patients hospitalized with influenza
[EMBARGOED FOR DEC. 14, 2011] The two main ways to prevent and control influenza today are annual immunization and antiviral drugs. A team of investigators has found that statins, cholesterol-lowering drugs, may offer an additional treatment to complement these approaches and reduce mortality among patients hospitalized with influenza. The findings are published in The Journal of Infectious Diseases and are now available online.
In an observational study led by Meredith L. Vandermeer, MPH, then with the Oregon Public Health Division in Portland, researchers used data for hospitalized adults during the 2007-2008 influenza season to evaluate the association between patients prescribed statins and influenza-related deaths. The data were drawn from the Centers for Disease Control and Prevention's Emerging Infections Program, which conducts active surveillance for patients hospitalized with confirmed influenza in 59 counties in 10 states.
Among 3,043 hospitalized patients with laboratory-confirmed influenza, 33 percent were given statin medications prior to or during hospitalization. After adjusting for various factors, patients not receiving statins were almost twice as likely to die from influenza as those who did receive the medication.
"Our study found that statins were associated with a decrease in odds of dying among cases hospitalized with laboratory-confirmed influenza, when adjusted for age, race, cardiovascular disease, chronic lung disease, renal disease, influenza vaccine receipt, and initiation of antivirals within 48 hours of admission," the study authors wrote.
You’ll find an accompanying editorial, also published today, titled:
Statins and Influenza: Can We Move Forward?
Edward E. Walsh
More than 2 years ago, the Reveres at the now shuttered Effect Measure Blog took an in depth look at the statin controversy, and why we still don’t know if they are effective against influenza.
While the Revere’s are greatly missed in Flublogia, that archive is still online, and very much worth revisiting.
Statins for influenza. Why don't we know if it works yet?
Category: Infectious disease • Influenza treatment
Statins for influenza are in the news again, this time because of a paper given at the Annual Meeting of the Infectious Disease Society of America (IDSA). We'll get to it in a moment, but first a little background.
For more on the potential utilization of statins during a pandemic, or for seasonal influenza and pneumonia, you may wish to revisit these earlier blogs:
