geoffrey modest medical blogs

  A recent article suggested  that the anti-inflammatory effects of pitavastatin may prevent pancreatic cancer by decreasing pancreatic inflammation (see statin dec pancreat cancer NatCommun2024  in dropbox, or doi.org/10.1038/s41467-024-48441-8)   Details:  -- see commentary below for more of the immunology and potential mechanisms   Results: -- mouse studies assessing chronic inflammation in the skin and pancreas: they created inflammation and fibrosis, documented that IL-33 expression was downstream of a specific signaling (TBK1-IRF-3), and that chronic inflammation depended on IL-33 induction -- they screened an FDA-approved drug library to assess the role of small molecules that would decrease IL-33 expression, finding 5 candidates. -- they found that pitavastatin calcium was an effective suppressant of IL-33 (as well as the bisphosphonate zoledronic acid)     -- pitavastatin suppressed a breast cancer cell line ...

the recent REPRIEVE trial found that the use of the new statin pitavastatin was very effective in decreasing cardiovascular events in those with controlled HIV infection and otherwise very low cardiovasc risk, as well as documenting its safety (see hiv pitavastatin dec cardiovasc dz NEJM2023 in dropbox, orDOI: 10.1056/NEJMoa2304146)   Details : -- 7769 patients aged 40 to 75 and with HIV infection on a stable antiretroviral therapy and a low-to-moderate risk of cardiovascular disease based on the 2013 AHA/ACC risk calculator were randomized to pitavastatin 4mg versus placebo -- median age 50, 65% nonwhite, 31% women; international study with 53% from high-income countries, 18% from Latin America/Caribbean, 15% sub-Saharan Africa, rest from Southeast/East/South Asia -- median CD4 count was 621 and the HIV viral load was below quantification (<20 copies/mL) in 88% of the participants and <400 in   98% (no comment on the HIV meds used) -- median screening LDL w...