title: Lovastatin for the Treatment of Adult Patients With Dengue: A Randomized, Double-Blind, Placebo-Controlled Trial.
abstract: BACKGROUND
  Dengue endangers billions of people in the tropical world, yet no therapeutic is currently available. In part, the severe manifestations of dengue reflect inflammatory processes affecting the vascular endothelium. In addition to lipid lowering, statins have pleiotropic effects that improve endothelial function, and epidemiological studies suggest that outcomes from a range of acute inflammatory syndromes are improved in patients already on statin therapy.
  
  
  METHODS
  Following satisfactory review of a short pilot phase (40 mg lovastatin vs placebo in 30 cases), we performed a randomized, double-blind, placebo-controlled trial of 5 days of 80 mg lovastatin vs placebo in 300 Vietnamese adults with a positive dengue NS1 rapid test presenting within 72 hours of fever onset. The primary outcome was safety. Secondary outcomes included comparisons of disease progression rates, fever clearance times, and measures of plasma viremia and quality of life between the treatment arms.
  
  
  RESULTS
  Adverse events occurred with similar frequency in both groups (97/151 [64%] placebo vs 82/149 [55%] lovastatin; P = .13), and were in keeping with the characteristic clinical and laboratory features of acute dengue. We also observed no difference in serious adverse events or any of the secondary outcome measures.
  
  
  CONCLUSIONS
  We found lovastatin to be safe and well tolerated in adults with dengue. However, although the study was not powered to address efficacy, we found no evidence of a beneficial effect on any of the clinical manifestations or on dengue viremia. Continuing established statin therapy in patients who develop dengue is safe.Chinese Clinical Trials Registration. ISRCTN03147572.
authors.affiliation: London School of Hygiene and Tropical Medicine, United Kingdom.|Oxford University Clinical Research Unit.
authors.forename: James
authors.initials: J
authors.lastname: Whitehorn
authors.affiliation: Hospital for Tropical Diseases, Ho Chi Minh City.
authors.forename: Chau Van Vinh
authors.initials: CVV
authors.lastname: Nguyen
authors.affiliation: Oxford University Clinical Research Unit.
authors.forename: Lam Phung
authors.initials: LP
authors.lastname: Khanh
authors.affiliation: Oxford University Clinical Research Unit.
authors.forename: Duong Thi Hue
authors.initials: DTH
authors.lastname: Kien
authors.affiliation: Oxford University Clinical Research Unit.
authors.forename: Nguyen Than Ha
authors.initials: NTH
authors.lastname: Quyen
authors.affiliation: Oxford University Clinical Research Unit.
authors.forename: Nguyen Thi Thanh
authors.initials: NTT
authors.lastname: Tran
authors.affiliation: Oxford University Clinical Research Unit.
authors.forename: Nguyen Thuy
authors.initials: NT
authors.lastname: Hang
authors.affiliation: Hospital for Tropical Diseases, Ho Chi Minh City.
authors.forename: Nguyen Thanh
authors.initials: NT
authors.lastname: Truong
authors.affiliation: Hospital for Tropical Diseases, Ho Chi Minh City.
authors.forename: Luong Thi
authors.initials: LT
authors.lastname: Hue Tai
authors.affiliation: Hospital for Tropical Diseases, Ho Chi Minh City.
authors.forename: Nguyen Thi
authors.initials: NT
authors.lastname: Cam Huong
authors.affiliation: Tien Giang Hospital, My Tho, Vietnam.
authors.forename: Vo Thanh
authors.initials: VT
authors.lastname: Nhon
authors.affiliation: Tien Giang Hospital, My Tho, Vietnam.
authors.forename: Ta
authors.initials: T
authors.lastname: Van Tram
authors.affiliation: Oxford University Clinical Research Unit.|Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Farrar
authors.affiliation: Oxford University Clinical Research Unit.|Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom.
authors.forename: Marcel
authors.initials: M
authors.lastname: Wolbers
authors.affiliation: Oxford University Clinical Research Unit.|Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom.|Department of Microbiology and Immunology, Peter Doherty Institute, University of Melbourne, Victoria, Australia.
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Simmons
authors.affiliation: Oxford University Clinical Research Unit.|Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom.
authors.forename: Bridget
authors.initials: B
authors.lastname: Wills
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003715:Dengue / Q000188:drug therapy* / Q000473:pathology*; D004311:Double-Blind Method; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008148:Lovastatin / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D010919:Placebos / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D014744:Vietnam; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D010919:Placebos; D008148:Lovastatin
keywords: dengue; lovastatin; randomized clinical trial