Physicians are making a case for statins and ARBs as a treatment for Ebola patients. They are not proposing the combination of drugs is a cure or preventive but rather an aid in survival to give patients time to build up immunity to the virus.
“Cardiologists have known for more than a decade that when statins and ARBs are given in combination to patients with cardiovascular disease, they have additive and synergistic activities in counteracting endothelial dysfunction,” wrote David S. Fedson, MD, a retired professor from the University of Virginia in Charlottesville. Three other authors joined him in the opinion article published June 23 in mBio.
The authors pointed to observational studies that suggested statins and ARBs may play a role in increased survival in patients with pneumonia and influenza and to a randomized trial that assessed atorvastatin in patients with early sepsis. Sepsis, like the Ebola virus, causes endothelial dysfunction and a breakdown of vascular barriers that lead to fluid loss and ultimately organ failure and death. Statins and ARBs may help preserve or restore endothelial barrier integrity, they proposed.
In what they admitted were “poorly documented results,” Fedson et al shared reports on the use of atorvastatin and irbesartan in about 100 Ebola patients being treated in hospitals and Ebola centers in Sierra Leon. Two patients died: one who was critically ill when admitted and another who stopped treatment after three days and switched to an antiviral agent. Most of the remaining patients showed “rapid clinical improvement” with the statin-ARB combination.
Statins and ARBs are inexpensive, safe, easy to administer and they can be given along with antiviral agents if available, they added. They called for government support for clinical trials to evaluate the host response to generic statins and ARBs in Ebola patients, using historical controls for comparisons.
“[I]f the results of treatment [seen in the Sierra Leon cases] can be validated, their use would transform the way Ebola virus disease is managed,” they wrote. “These agents might also find use in the syndromic treatment of other severe infectious diseases.”