HMG-CoA Reductase Inhibitors for Traumatic Brain Injury

Authors

Kalman Katlowitz
Shankar Gopinath
Jovany Cruz Navarro
Claudia Robertson

Publication Date

10-1-2023

Journal

Neurotherapeutics

DOI

10.1007/s13311-023-01399-9

PMID

37351829

PMCID

PMC10684840

PubMedCentral® Posted Date

6-23-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Retrospective Studies, Cholesterol, Brain Injuries, Traumatic, Inflammation, Randomized Controlled Trials as Topic, Traumatic brain injury, Statins, Trauma, Inflammation, Concussion, Inflammation, Cholesterol

Abstract

Traumatic brain injuries (TBIs) are associated with high morbidity and mortality due to both the original insult as well as the destructive biological response that follows. Medical management aims to slow or even halt secondary neurological injury while simultaneously laying the groundwork for recovery. Statins are one class of medications that is showing increased promise in the management of TBI. Used extensively in cardiovascular disease, these drugs were originally developed as competitive inhibitors within the cholesterol production pipeline. They are now used in diverse disease states due to their pleiotropic effects on other biological processes such as inflammation and angiogenesis. Preclinical studies, retrospective reviews, and randomized clinical trials have shown a variety of benefits in the management of TBI, but to date, no large-scale randomized clinical trial has been performed. Despite this limitation, statins' early promise and well-tolerated side effect profile make them a promising new tool in the management of TBIs. More bench and clinical studies are needed to delineate proper treatment regimens as well as understand their true potential.