Article

The effects of statin therapy on inflammatory cytokines in patients with bacterial infections: a randomized double-blind placebo controlled clinical trial.

Department of Medicine, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beersheba, Israel.
European Journal of Intensive Care Medicine (impact factor: 5.17). 03/2009; 35(7):1255-60. DOI:10.1007/s00134-009-1429-0 pp.1255-60
Source: PubMed

ABSTRACT To determine if statin therapy reduces the incidence of severe sepsis and the levels of inflammatory cytokines in patients with acute bacterial infection.
Double-blind placebo controlled randomized clinical trial.
Department of medicine and medical intensive care unit in a tertiary university medical center.
A total of 83 patients with suspected or documented bacterial infection were enrolled. We randomly assigned 42 patients to receive 40 mg of simvastatin orally, followed by 20 mg of simvastatin, and 41 to receive matching placebo.
The study was prematurely terminated due to slow recruitment rate. Here we report the analysis of the secondary outcome: change in cytokines levels at 72 h. Both groups were evenly matched in terms of co-morbidity and severity of illness on admission. Four of the 83 patients enrolled developed severe sepsis, two in each group. No difference was observed in other clinical variables and there were no mortalities. Cytokine levels were randomly assessed in 40 patients (20 in each group). Both TNF-alpha and IL-6 levels were significantly reduced in the simvastatin group (p = 0.02 and p = 0.02, respectively), while no such difference was observed in the placebo group (p = 0.35 and 0.39, respectively).
Statin therapy may be associated with a reduction in the levels of inflammatory cytokines in patients with acute bacterial infections. Large controlled trials will determine if this reduction will translate into a clinical benefit.

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    Jaimin M Patel, Catherine Snaith, David R Thickett, Lucie Linhartova, Teresa Melody, Peter Hawkey, Anthony H Barnett, Alan Jones, Tan Hong, Matthew W Cooke, Gavin D Perkins, Fang Gao
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Keywords

40 patients
 
42 patients
 
83 patients
 
acute bacterial infection
 
acute bacterial infections
 
clinical benefit
 
clinical variables
 
documented bacterial infection
 
Double-blind placebo
 
IL-6 levels
 
inflammatory cytokines
 
medical intensive care unit
 
placebo group
 
randomized clinical trial
 
secondary outcome
 
severe sepsis
 
simvastatin group
 
simvastatin orally
 
slow recruitment rate
 
tertiary university medical center