Simvastatin may lead to faster improvement in Covid-19 patients admitted to the intensive care unit (ICU). This is what the many researchers of the REMAP-CAP study write The New England Journal of Medicine.
In the period from October 2020 to early 2023, the researchers included a total of 2,648 Covid-19 patients who were admitted to the ICU and received some form of organ support, such as pulmonary ventilation or administration of blood pressure-raising medication (vasopression). Patients were randomized to no simvastatin or simvastatin 80 mg daily until the first day of ICU discharge or, otherwise, until day 28.
The primary outcome measure was a score that combined mortality with the number of days the patient was free of organ support, within a maximum period of 21 days. The higher the score, the better the outcome. The median number of days without organ support in the simvastatin group was 11, and in the control group it was 7. The researchers calculated that it is 95.9 percent certain that simvastatin is better than the standard treatment. The researchers note that the 99 percent threshold was not exceeded at which it would be clear that simvastatin is truly superior. In addition, the percentage of ‘serious adverse events’, in the form of elevated liver enzymes, was higher in the simvastatin group (3.1%), compared to the control group (2.0%).
There have now been seven other randomized controlled trials into the effect of statins on Covid-19. The REMAP-CAP study, in which the UMC Utrecht is participating, is larger than these previous trials. Intensivist Lennie Derde (UMC Utrecht), involved in the study as European research leader, states in a press release: ‘These results are really encouraging, because simvastatin is a cheap drug with limited side effects.’ Simvastatin is known to have an anti-inflammatory and immunomodulatory effect, in addition to its cholesterol-lowering effect. The hypothesis is that it reduces systemic and pulmonary inflammation.
DOI: 10.1056/NEJMoa2309995 Also read
2023-10-27 11:18:16
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