Tuesday, May 01, 2012

Lancet: David Fedson On Statins For Pandemic Influenza

 

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Photo Credit CDC PHIL

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Dr. David Fedson – former Professor of Medicine at the University of Virginia School of Medicine and formerly Director of Medical Affairs, Aventis Pasteur MSD - has long championed the idea that we should be looking at statins for pandemic flu, which he believes may help modulate the immune response.

 

If they can be proved effective, statins have the advantage of being cheap, easy to manufacture and distribute, and have relatively few side effects.

 

A couple of earlier papers from Dr. Fedson 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

 

 

The big `if’ in all of this is just how beneficial statins really are for pandemic influenza, and while we’ve a number of encouraging studies, not all have shown positive results.


A quick roundup includes:

 

Statin drugs lower respiratory death risk: study

Tue Apr 10, 2007 12:40pm EDT

By Maggie Fox, Health and Science Editor

 

A study presented in October of 2009 at the annual meeting of the IDSA, the Infectious Diseases Society of America, in Philadelphia suggested 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.

 

Again in 2011, a study by the London School of Hygiene and Tropical Medicine published in the BMJ –looked at 6 month post-pneumonia survival rates among those taking statins, and those not taking these medications.

 

While there may have been other factors at work - survival rates were considerably higher (87% vs 80%) among those already taking statins when they fell ill  (see Statins & Pneumonia: Revisited).

 

But not all of the studies have 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.

 

 

So while not all of these studies are in agreement, many of them have supported the notion that statins may be of considerable value during a pandemic, and may contribute to the survival rate of patients with pneumonia.

 

Which brings us to a short op-ed piece in The Lancet today, where Dr. Fedson and Steven M. Opal write on what they see as the practical response to the H5N1 transmission study controversy.

 

 

The Lancet Infectious Diseases, Volume 12, Issue 5, Pages 364 - 365, May 2012

doi:10.1016/S1473-3099(12)70079-8

Research into transmissibility of influenza A H5N1: a practical response to the controversy

David S Fedson , Steven M Opal

 

Access to this article requires free registration.

 

The authors maintain that the real issue is not whether or not the controversial H5N1 studies should be published, but rather, why influenza scientists and their sponsors have not undertaken serious research into the efficacy and effectiveness of immunomodulatory agents (like statins) in treating pandemic flu.

 

Unfortunately, the answer to that question may simply boil down to the fact that since many statins are off-patent - and can sold generically for pennies a pill - there is little financial incentive for the pharmaceutical industry to invest a lot of money into laboratory and clinical research.


Assuming the real priority is saving lives during a pandemic, what is needed is government sponsorship of appropriate research, or a private support by a non-profit organization with deep pockets.

 

For more on statins, and their potential role in pandemic influenza, you may wish to revisit:

 

Study: Statins, Influenza, & Mortality

Another Study On Statins And Pneumonia

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

First Statins, Now Fibrates

Statins Revisited