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Roshini Claire Anthony, 23 Mar 2016
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Statins not protective against dengue in infected patients with hyperlipidaemia

Jairia Dela Cruz
29 Nov 2018

Statins appear to confer no benefit for dengue severity in patients with hyperlipidaemia, according to a Singapore study.

Specifically, use of the lipid-lowering medication upon hospital admission does not reduce dengue severity in infected hyperlipidaemia patients, the investigators said. “However, prior use of statins is not a risk factor for increased liver inflammation and supports the safety of continuing statins in patients with dengue.”

The study population included 257 dengue patients (mean age 61.3 years; 51.0 percent female) with a history of hyperlipidaemia, among whom 191 (74.3 percent) were statin users and 66 (25.7 percent) were nonusers. Medications used included simvastatin (69.1 percent), lovastatin (17.3 percent), atorvastatin (8.4 percent), rosuvastatin (4.2 percent) and pravastatin (1.0 percent).

Compared with nonusers, statin users were significantly more likely to be overweight or obese, have a history of hypertension and chronic liver disease. Moreover, users were more likely to develop tachycardia and fluid accumulation and severe plasma leakage.

Multivariate Poisson regression analysis showed no association between statin use and reduced risk of both dengue haemorrhagic fever/shock syndrome (adjusted risk ratio [aRR], 0.66; 95 percent CI, 0.41–1.08; p=0.10) and severe dengue (aRR, 1.43; 0.84–2.43; p=0.19). [Sci Rep 2018;8:17147]

The risk estimates indicate that statin usage has minimal effect on dengue severity in the study population in Singapore, the investigators pointed out.

Despite the presence of several limitations, the present data “suggest that discontinuation of statins may not be necessary at the onset of dengue infection, and clinicians may adopt a watchful approach of continuing statins,” they added.

While discontinuation of statins may not be harmless even for short periods of time, an abrupt withdrawal has been shown to lead to impaired endothelial function via nitric oxide release and higher C-reactive protein levels, resulting in a proinflammatory state. [J Pharmacol Exp Ther 2011;339:324-328]

“With an ageing population compounded by a rise in obesity and associated comorbidities in Singapore, it is not uncommon that patients can present with dengue on a background of multiple medical problems that may pose a therapeutic challenge,” they said.

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Most Read Articles
Roshini Claire Anthony, 23 Mar 2016
Diabetics with poor glycaemic control and disease-related complications have an elevated risk of community-acquired Staphylococcus aureus bacteraemia (CA-SAB), according to a recent Danish study.
Dr. Joseph Delano Fule Robles, 3 days ago

A team of investigators from the University of Hong Kong (HKU) identified high-risk Epstein Barr virus (EBV) variants present in 97 percent of nasopharyngeal carcinoma (NPC) cases.

Roshini Claire Anthony, 01 Apr 2016
Almost a quarter of older patients who are discharged from an acute care hospital and admitted into a post-acute care (PAC) facility carry multidrug-resistant organisms (MDROs) on their hands, show results of a recent study.
Yesterday
New drug applications approved by US FDA as of 01- 15 February 2019 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.