Could statins help treat Ebola?

In an article in the New York Times, two physicians propose using drugs that are currently available to treat Ebola.

Ebola causes a derangement in endothelial cells (cells lining blood vessels), and this can lead to decreased ability of the patient’s blood to clot. This can lead to internal and external bleeding, and shock and damage to visceral organs like the liver and kidneys.

The doctors note that this process is similar to sepsis, a condition where the body is trying to cope with an overwhelming infection. In severe sepsis, there is often bleeding, shock, organ failure and death.

There have been a number of studies where statins have been given to patients with sepsis because some work has shown that statins can help prevent or slow the above process.

The physicians also note that two other classes of drugs, angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers, seem to have similar effects to statins in prevention or halting the above process.

The doctors suggest that members of those three classes of drugs might be helpful in treating Ebola patients. However, to date, these drugs have not been given to Ebola patients because their effects have not been studied in those patients. Just because they have been shown to help in patients with sepsis, does not mean that they will necessarily help in Ebola. Since that is the case, the World Health Organization is notably reluctant to suggest that these drugs be used in Ebola patients. However, it is an interesting proposal and will require much thought. If numbers of Ebola patients continue to increase, and other treatment options are lacking, these drugs might be given.

Ebola life cycle, from the CDC.

Ebola life cycle, from the CDC.

A vaccine, untested in humans, is being sent to the area. The drug, developed by the US and Canada was given to the WHO to use in the area. About 1,000 doses were sent.

Mapp Biopharmaceuticals will attempt to make more ZMAPP. (ZMapp is the experimental drug given to Brantly, Writebol and a few others.) They have shipped all of what they had on hand to the affected area. Tekmira, maker of TKM-Ebola (a drug that can be given after someone is exposed to the virus) has approval to fast-track the drug through the FDA. They are considering how to release what supplies that they have available. Another US research lab may be able to start testing its vaccine in early trials as early as next month. That would make two vaccines going into testing.

The bad news is, this is a process that will take months (for ZMapp production) to years (vaccine testing and production) before any measurable amount of drug is available. Realize that Liberia has a population of about 4,000,000. Lagos, Nigeria has an estimated population of about 21,000,000. There would be a need for a vast number of medicines and vaccines to treat/protect just those people. The production of enough medicine for all to those people, if needed, would be a staggering task. So these drugs aren’t going to be what stops Ebola now. Quarantine and control will be the chief agents to stem the disease. And, in more bad news, there are now scammers now who are offering anti-Ebola “medications” and anti-Ebola “vaccines” and other treatments both online and in the marketplaces of the affected countries.

In other Ebola news, the WHO is now saying that the Ebola outbreak in the affected areas of Africa, is much larger than they first thought. As I wrote in an earlier article,  doctors who had been on the ground in the area, and infectious disease specialists, were saying that the outbreak was probably much larger than the numbers released based on those seeking treatment. They predicted that as high as 75% of cases were not diagnosed, as they didn’t present for treatment. They may have just stayed home, fled or died. Also, Doctors Without Borders said weeks ago that they were overwhelmed by just the number of reported cases of Ebola.

Guinea has declared a public health emergency over Ebola. It joins Nigeria, Liberia and Sierra Leone who had all previously done the same.

The government there says that its Ebola outbreak is “under control” and numbers of cases inside its borders are decreasing. Whether that is true or not is a matter of debate for two reasons. First, sometimes the local governments are somewhat less than honest about reporting information such as this. The Ebola outbreak is costing the area’s economies millions of dollars that they cannot afford to lose. They certainly want to do as much damage control as possible. Additionally, the press in those areas tends to be somewhat less than factual, at times. So the reporting from the area may be suspect. Also, a few months ago, the number of Ebola cases in the area actually were falling, but then they began to spike again. This seems to be the pattern with Ebola. Appear, infect, spread, wane, disappear. When the incidence of cases declined, people thought that the outbreak was over.

More airlines are suspending flights to the affected countries and neighboring countries. Meetings and conferences in the area are being canceled. The Youth Olympic Games is banning some West African athletes from competing because, the IOC feels, that there is a risk of transmitting the virus if infected athletes participate in swimming events. West Africans will also be banned from a few other sports at the Games in China.

US patient Kent Brantly is looking forward to getting discharged. SIM, a Christian Missionary group, says that he’s feeling much better, but a discharge date has not been set.

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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6 Responses to “Could statins help treat Ebola?”

  1. Naja pallida says:

    It’s a current and significant event, and there aren’t many sites actually exploring it beyond “Yep, some people in Africa are sick.”

  2. BloggerDave says:

    What’s the fascination with Ebola on this website?

  3. Naja pallida says:

    I’m no doctor, but it doesn’t really seem to be a great idea to me. Statins require a fully functional liver to be safely effective. ACE inhibitors and ARBs are both known to have a significant potential for causing renal impairment. So in order for them to be at all safe for treatment, it would have to be in the very earliest stages, before Ebola begins to impair liver and kidney function. Seems to me that it would be potentially increasing their risk for organ failure.

    Even vaccines currently in use, backed with big-pharm money, take about six months to produce a ‘batch’. Something experimental, without a significant source of money behind it, intending to be given away in poor countries? It will be a miracle if any kind of treatment gets to them at all.

  4. nicho says:

    Then, I’m screwed. I can’t tolerate statins. Tried ’em all. For me, they’re horrible.

  5. BeccaM says:

    That’s odd… I thought statins were contraindicated for treatment of hemorrhagic stroke victims. Or at least not recommended.

  6. Baal says:

    Possibly also anti-TNF therapy.

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