Statins reduce healthy volunteers’ inflammatory response to inhaled or injected lipopolysaccharide. Craig et al report the results of HARP, in which the UK investigators gave 80 mg of simvastatin or placebo to 60 patients with acute lung injury and ARDS, for up to 14 days. There were no differences in mortality (30%), ventilator-free days or ICU/hospital stay. However, the one-third of the treated group who were left to analyze after 14 days had significantly lower SOFA organ dysfunction scores. They also had a non-statistically significant improvement in hemodynamics at day 14 (0 of 9 [simvastatin] vs. 3-4 of 10 [placebo] requiring vasopressors or inotropes, p=0.05-0.09), and significantly lower IL-8 in BAL fluid. No adverse events were noted. Larger trials are underway to explore this further. (n=60). AJRCCM 2011;183:620-626.