Cholesterol-lowering drugs used to prevent heart attacks and stroke
may also help fight a pandemic sparked by bird flu, and should be
tested, said a physician who has studied immunization for decades.

Medicines such as Pfizer Inc.'s Lipitor, the world's best- selling
drug, have helped patients with sepsis and pneumonia in observational
studies, indicating a potential to reduce deaths from bird flu, said
David Fedson, former director of European medical affairs for
Sanofi-Aventis SA, who spoke at an avian influenza conference in Paris
today.

Vaccines and antiviral drugs will likely be unavailable in many places
in the early months of a pandemic, and researchers should study
alternative therapies to fill the gap, Fedson said. Lipitor, Merck &
Co.'s Zocor and similar medicines, known as statins, also may be
acquired more cheaply than vaccines and antivirals because of generic
competition.

``It's an idea,'' Fedson, who is also a former professor of medicine
at the University of Virginia, said in an interview yesterday in
Paris. ``Experimental, clinical and epidemiological evidence suggests
that statins might be protective. The clinical and public health need
for something that is available is immense.''

Merck's Zocor lost its patent protection June 23, opening the door to
more generic competition. The worldwide market for cholesterol
treatments is about $22 billion a year.

Cheaper Than Tamiflu

A five-day course of generic Zocor, chemically known as simvastatin,
will cost as little as $1.75 in the U.S., and costs about 50 cents in
developing countries such as India, Fedson said. A five-day course of
Roche Holding AG's antiviral Tamiflu costs about $60 to $90 in the
U.S., he said.

The World Health Organization said last month that Tamiflu, or
oseltamivir, should be the first choice for doctors treating people
with avian flu. The drug inhibits the multiplication of influenza
viruses, helping fight infection.

Disease trackers are monitoring the H5N1 virus in the event it evolves
into a pandemic form capable of killing millions of people. Since late
2003, H5N1 is known to have infected at least 228 people, mainly in
Asia, killing 130 of them, according to the WHO.

Fedson, 68, is a Yale University-educated physician with a special
interest in infectious diseases and the cost- effectiveness of
vaccines in public health. He served on the national vaccine advisory
committee in the U.S. between 1990 and 1994 and worked for Sanofi in
Europe for seven years.

Research Needed

Influenza increases the risk of heart attack and stroke and induces
the production of proteins that promote inflammation. The immune
response to influenza infection can cause acute respiratory distress
syndrome, associated with mortality in H5N1 cases. Statins decrease
these risks, Fedson said.

In a report published by the journal Intensive Care Medicine this
year, in an observational study of 438 patients with bacterial sepsis,
statin treatment during hospitalization reduced the rate of death
attributable to sepsis by 92 percent, Fedson said. In a similar study
of 388 patients, the mortality rate was cut by 87 percent. That study
was published in Clinical Infectious Diseases in 2001.

Fedson urged statin makers and other researchers to provide data on
the drugs and their effect on respiratory illnesses, and said the
hypothesis should be tested in animals and people infected with flu.

Merck spokeswoman Janet Skidmore said in a telephone interview
yesterday that she couldn't comment. Pfizer did not return calls
seeking comment.

New Hope?

``Statins are a potential treatment, but there are also alternative
ways to modulate the immune system,'' said Menno de Jong, head of the
virology department at the Oxford University Clinical Research Unit in
Ho Chi Minh City, Vietnam. De Jong's team observed 18 H5N1 cases in
the Southeast Asian nation.

De Jong, whose unit is coordinating an initial clinical study of
Tamiflu in human H5N1 cases, said subsequent trials could investigate
other treatments, including statins.

The WHO said in November that if current trends persist, most
developing countries won't have access to a vaccine during the first
wave of a pandemic. If effective, statins may provide some hope for
poorer countries that don't have the money to buy large quantities of
antiviral medicines and vaccines or the capacity to make them.

Pomegranate Juice, Green Tea

``I come from Africa, where we have no vaccines, no antivirals'' to
treat a flu outbreak, said Girish Kotwal, a virologist at the
University of Cape Town School of Medicine in South Africa. ``The WHO
has enough antivirals to treat 3 million, but how much of that will
trickle down to Africa? Maybe none.''

Kotwal presented data that indicate that the plant trifolium, a type
of clover, along with pomegranate juice may have antiviral properties
that could be developed for use against bird flu.

A Korean researcher, Baik-Lin Seong of Yonsei University in Seoul,
said a chemical found in green tea blocked a flu virus's ability to
attach to cells, and may be processed into a treatment. Star anise, a
plant found in China, is used in the production of Tamiflu.

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# posted by Network @ 12:14 AM