Flu Expert Urges More Research on Statins

PARIS — Public health authorities should develop a research agenda on the use of statins as treatment and prophylaxis in the event of an influenza pandemic, a top researcher said at an international conference on avian influenza in humans.

Data suggest that statins could be useful in combating such side effects as pneumonia, sepsis, bacteremia, and pulmonary disease, said Dr. David Fedson, coordinator of the Macroepidemiology of Influenza Vaccination (MIV) Study Group and a former professor of medicine at the University of Virginia, Charlottesville. Statins could be an alternative treatment in the first wave of a pandemic, when vaccines may be unavailable.

Statins can interfere with inflammation and with virus transport, assembly, and budding, while aiding endothelial and epithelial cell function and immune response, Dr. Fedson said. These qualities could make statins an effective treatment option in the event that avian influenza H5N1 mutates into a form that can infect humans more easily.

Should such a mutation take place, vaccine manufacturers first will need to match their vaccine to the virus and then ramp up production, which will mean that the first regions to be affected could be defenseless against the pandemic.

“In the event of an H5N1 pandemic, the global demand will easily be on the order of 3–4 billion doses, and probably much more,” Dr. Fedson said.

“Yet today, if the world's vaccines companies were asked to produce [vaccine], in 6 months they could produce enough … to vaccinate fewer than 100 million people. Vaccination will not be a realistic possibility for 85% of the world's population that do not live in countries with vaccine companies, and it will be difficult even for those who do,” he said.

By comparison, generic statins are inexpensive—$1.75 for 5 days' worth of dosage in the United States—and they can be produced worldwide, Dr. Fedson said.

Among the evidence in favor of statins' protective qualities, Dr. Fedson said, are studies showing a reduction of up to 92% in bacteremia-attributable mortality among patients who take statins; a reduction of up to 25% in sepsis mortality among patients who have previously taken statins; and a 53% reduction in 30-day pneumonia mortality among those patients who have taken statins.

However, international health officials need to embark on a statin research agenda to explore unanswered questions, Dr. Fedson said.

To understand whether statins are an option, researchers need to perform clinical and epidemiologic studies examining hospitalization and mortality.

They also must clearly compare the effects of previous statin use with continuing statin use, and compare treatment with prophylaxis. In addition, researchers need to do animal studies with mice, ferrets, and primates, and more clearly determine the molecular mechanism of action, he noted.

PARIS — Public health authorities should develop a research agenda on the use of statins as treatment and prophylaxis in the event of an influenza pandemic, a top researcher said at an international conference on avian influenza in humans.

Data suggest that statins could be useful in combating such side effects as pneumonia, sepsis, bacteremia, and pulmonary disease, said Dr. David Fedson, coordinator of the Macroepidemiology of Influenza Vaccination (MIV) Study Group and a former professor of medicine at the University of Virginia, Charlottesville. Statins could be an alternative treatment in the first wave of a pandemic, when vaccines may be unavailable.

Statins can interfere with inflammation and with virus transport, assembly, and budding, while aiding endothelial and epithelial cell function and immune response, Dr. Fedson said. These qualities could make statins an effective treatment option in the event that avian influenza H5N1 mutates into a form that can infect humans more easily.

Should such a mutation take place, vaccine manufacturers first will need to match their vaccine to the virus and then ramp up production, which will mean that the first regions to be affected could be defenseless against the pandemic.

“In the event of an H5N1 pandemic, the global demand will easily be on the order of 3–4 billion doses, and probably much more,” Dr. Fedson said.

“Yet today, if the world's vaccines companies were asked to produce [vaccine], in 6 months they could produce enough … to vaccinate fewer than 100 million people. Vaccination will not be a realistic possibility for 85% of the world's population that do not live in countries with vaccine companies, and it will be difficult even for those who do,” he said.

By comparison, generic statins are inexpensive—$1.75 for 5 days' worth of dosage in the United States—and they can be produced worldwide, Dr. Fedson said.

Among the evidence in favor of statins' protective qualities, Dr. Fedson said, are studies showing a reduction of up to 92% in bacteremia-attributable mortality among patients who take statins; a reduction of up to 25% in sepsis mortality among patients who have previously taken statins; and a 53% reduction in 30-day pneumonia mortality among those patients who have taken statins.

However, international health officials need to embark on a statin research agenda to explore unanswered questions, Dr. Fedson said.

To understand whether statins are an option, researchers need to perform clinical and epidemiologic studies examining hospitalization and mortality.

They also must clearly compare the effects of previous statin use with continuing statin use, and compare treatment with prophylaxis. In addition, researchers need to do animal studies with mice, ferrets, and primates, and more clearly determine the molecular mechanism of action, he noted.

PARIS — Public health authorities should develop a research agenda on the use of statins as treatment and prophylaxis in the event of an influenza pandemic, a top researcher said at an international conference on avian influenza in humans.

Data suggest that statins could be useful in combating such side effects as pneumonia, sepsis, bacteremia, and pulmonary disease, said Dr. David Fedson, coordinator of the Macroepidemiology of Influenza Vaccination (MIV) Study Group and a former professor of medicine at the University of Virginia, Charlottesville. Statins could be an alternative treatment in the first wave of a pandemic, when vaccines may be unavailable.

Statins can interfere with inflammation and with virus transport, assembly, and budding, while aiding endothelial and epithelial cell function and immune response, Dr. Fedson said. These qualities could make statins an effective treatment option in the event that avian influenza H5N1 mutates into a form that can infect humans more easily.

Should such a mutation take place, vaccine manufacturers first will need to match their vaccine to the virus and then ramp up production, which will mean that the first regions to be affected could be defenseless against the pandemic.

“In the event of an H5N1 pandemic, the global demand will easily be on the order of 3–4 billion doses, and probably much more,” Dr. Fedson said.

“Yet today, if the world's vaccines companies were asked to produce [vaccine], in 6 months they could produce enough … to vaccinate fewer than 100 million people. Vaccination will not be a realistic possibility for 85% of the world's population that do not live in countries with vaccine companies, and it will be difficult even for those who do,” he said.

By comparison, generic statins are inexpensive—$1.75 for 5 days' worth of dosage in the United States—and they can be produced worldwide, Dr. Fedson said.

Among the evidence in favor of statins' protective qualities, Dr. Fedson said, are studies showing a reduction of up to 92% in bacteremia-attributable mortality among patients who take statins; a reduction of up to 25% in sepsis mortality among patients who have previously taken statins; and a 53% reduction in 30-day pneumonia mortality among those patients who have taken statins.

However, international health officials need to embark on a statin research agenda to explore unanswered questions, Dr. Fedson said.

To understand whether statins are an option, researchers need to perform clinical and epidemiologic studies examining hospitalization and mortality.

They also must clearly compare the effects of previous statin use with continuing statin use, and compare treatment with prophylaxis. In addition, researchers need to do animal studies with mice, ferrets, and primates, and more clearly determine the molecular mechanism of action, he noted.