Condition category
Infections and Infestations
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status
Results overdue

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Dr John Marshall


Contact details

St. Michael's Hospital
30 Bond Street
M5B 1W8
+1 416 864 6060 ext. 5225

Additional identifiers

EudraCT number number


Protocol/serial number


Study information

Scientific title

A double-blind placebo-controlled randomised pilot trial of the utility of statins as an adjuvant anti-inflammatory treatment in critically ill adults with suspected, probable or confirmed H1N1



Study hypothesis

Data from both observational studies in humans and interventional studies in animals suggest that the course of influenza can be favourably influenced by agents that are not classically considered to be treatments for influenza. As many of these treatments are inexpensive and readily available, and because they may provide independent benefit in viral infection, they are attractive adjuvant treatments for patients around the world, and ideally suited to use during a global pandemic. Our focus will be on the potential utility of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors (statins) as an adjuvant anti-inflammatory treatment in critically ill adults with suspected, probable or confirmed H1N1 based on theoretical potential for benefit and promising experimental studies.

Ethics approval

1. St Michael's Hospital Research Ethics Office approved on the 23rd December 2009 (ref: 09-314)
2. Comite d'ethique de la recherche de l'institut universitaire de cardiologie et de pneumologie de Quebec approved on the 2nd February 2010 (ref: HL-4610)
3. King Abdulaziz University Hospital Biomedical and Research Committee approved 30th January 2010 (ref: 340-10)

All other centres will seek ethics approval before recruiting participants.

Study design

Double blind placebo controlled pilot randomised trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type


Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Critically ill influenza A/H1N1 infection


Please note that as of 29/11/10 the anticpated end date of this study has been extended from 30/08/10 to 30/08/11. This trial is in the recruitment phase.

Experimental drug: Rosuvastatin (Crestor®) -
The first dose of encapsulated study drug (day 1) will be administered within 4 hours of randomisation as a loading dose of 40 mg. Thereafter, doses of 20 mg will be administered daily starting on the next calendar day at 10 pm (+/- 4 hours) as a maintenance dose from days 2 to 14. If the patient is of Asian descent, is aged less than 18 years, or serum creatinine is greater than or equal to 248 µmol/L (2.8 mg/dL) dose adjustments will be made according to a dose adjustment algorithm.

Placebo Comparator -
An identical appearing placebo will be administered to patients in the second study arm and administered once daily through an enteral feeding tube or administered orally if the patient is able to safely take oral medications.

Total duration of treatment: 14 days (both arms)
Total duration of follow-up: 90 days (both arms)

Intervention type



Phase II

Drug names

Rosuvastatin (Crestor®)

Primary outcome measure

Proportion of eligible patients enrolled in the CHAT Pilot Trial. Feasibility for the pilot study will be assessed by metrics that reflect our capacity to ultimately recruit a representative sample of 1050 patients in the planned full CHAT trial. We will consider the study to be feasible if we recruit at least 30% (commonly used threshold in ICU studies) of all eligible patients in participating ICUs through careful review of site screening logs.

Secondary outcome measures

1. Adherence to the medication administration regimen as outlined in the study protocol
2. Proportion of completed primary and secondary endpoints for the planned full CHAT trial that are collected
3. The number of patients who receive open-label statins
4. The number of consent withdrawals
5. Recruitment rates by approved consent model

All outcomes will be measured upon termination of this pilot study. However, adherence to medication administration will be recorded daily on study days 1 through 14 for each study subject.

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

1. Critically ill adult patients greater than 16 years of age (either sex) admitted to an adult intensive care unit (ICU) for any reason with suspected, probable or confirmed novel swine origin influenza A/H1N1 infection
2. Requiring mechanical ventilation (invasive or non-invasive)
3. Receiving antiviral therapy (any medication at any dose and for any intended duration) for less than 72 hours
4. Attending physician or intensivist must have a 'moderate' to 'high' index of suspicion for H1N1

Participant type


Age group




Target number of participants


Participant exclusion criteria

1. Aged less than 16 years
2. Do not resuscitate or re-intubate order documented on chart or anticipated withdrawal of life support
3. Weight less than 40 kg
4. Unable to receive or unlikely to absorb enteral study drug (e.g. incomplete or complete bowel obstruction, intestinal ischaemia, infarction, short bowel syndrome)
5. Rosuvastatin specific exclusions:
5.1. Already receiving a statin (atorvastatin, lovastatin, simvastatin, pravastatin, rosuvastatin)
5.2. Allergy or intolerance to statins
5.3. Receiving niacin, fenofibrate, cyclosporine, gemfibrozil, any protease inhibitor (including but not limited to lopinavir, ritonavir) or planned use of oral contraceptives or estrogen therapy during the Intensive Care Unit (ICU) stay
5.4. Creatine kinase (CK) exceeds 5,000 U/L or alanine aminotransferase (ALT) exceeds 8 times the upper limit of normal (ULN)
6. Severe chronic liver disease (Child-Pugh Score 11 - 15)
7. Previous enrolment in this trial
8. Pregnancy or breast feeding
9. At the time of enrolment, receipt of greater than 72 hours of antiviral therapy
10. Known or suspected clinically significant myositis or myopathy

Recruitment start date


Recruitment end date



Countries of recruitment

Argentina, Australia, Canada, Mexico, New Zealand, Saudi Arabia

Trial participating centre

St. Michael's Hospital
M5B 1W8

Sponsor information


St Michael's Hospital (UK)

Sponsor details

30 Bond Street
M5B 1W8

Sponsor type

Hospital/treatment centre



Funder type

Research organisation

Funder name

Canadian Institutes of Health Research (CIHR) (Canada) - (ref: 102785)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Funder name

Public Health Agency of Canada (PHAC) (Canada) (ref: 09-137443-391)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Funder name

Physician's Services Incorporated (PSI) Foundation (Canada)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

2011 protocol in:

Publication citations

Additional files

Editorial Notes

08/03/2019: Publication reference added.