Can Statins Reduce Deaths in Patients with Influenza?


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HGM coA Reductase with Compactin: Image courtesy of the NCBI Structure Database

Statins are cholesterol-lowering drugs that have recently been found to have possible therapeutic effects in hospitalized patients with influenza. A study released on December 14th demonstrated that these drugs can not only lower blood cholesterol, but can also reduce your chance of dying from flu complications.

Statins – How Do They Work?

Statins, also known as HMG-CoA reductase inhibitors, are drugs commonly prescribed to reduce blood cholesterol levels. Medications like simvastatin, atorvastatin and pravastatin work by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver. Increased cholesterol levels have been associated with cardiovascular diseases, and statins are popularly used in the prevention of these diseases.

Now, however, another use for statins has been proposed: drugs which inhibit HMG-CoA reductase may reduce deaths due to the complications of influenza, as observed in a study involving 3043 hospitalized patients in the period covering 2007-2008. Using the same pathway that inhibits the production of cholesterol, a signaling pathway activates numerous immune mechanisms that have anti-inflammatory and immunomodulatory properties. These result in a decrease in lymphocyte stimulation and proliferation, as well as reduction of the production of cytokines.

The Association Between Influenza Mortality and Use of Statins: A Review

An observational study was conducted by a team of researchers led by Meredith L. Vandermeer, MPH, (then with the Oregon Public Health Division in Portland), using the hospital records of over 3000 adult patients during the 2007-2008 influenza season to evaluate the association between patients using statins and influenza-related deaths. They analyzed data drawn from the Centers for Disease Control and Prevention’s Emerging Infections Program, which handles active surveillance for hospitalized patients with laboratory-confirmed influenza in 59 counties in 10 states.

By the nature of their mechanism of action, it has been suggested that statins have anti-inflammatory effects in both infectious and non-infectious disease processes such as bone disease, diabetes and cardiovascular disease, and more recently, sepsis, community-acquired pneumonia, and influenza. Although there have been previous observational studies that have shown these results, Vandermeer and associates say that their work is “the first to look at lab-confirmation of influenza which avoids the uncertainty of disease classification that comes with using administrative data. Our cohort size was also large enough to provide ample power to detect a statistically significant result.”

Results of their observations supported previous studies such as those by Frost et al. (2007) and Kwong et al.(2009), which showed that patients who have been previously taking statins or given these medications while being hospitalized were less likely to die from influenza than those who did not use statins at all.

However, an observational study that relies solely on previous records or chart reviews has its weaknesses and limitations compared to a controlled, randomized study.

Click for Page Two: Further Studies Needed

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