Lipid Lowering Therapy with Fluvastatin and Pravastatin in Patients with HIV Infection and Antiretroviral Therapy: Comparison of Efficacy and Interaction with Indinavir

Benesic, Andreas; Zilly, Michael; Kluge, Friedrich; Weißbrich, Benedikt; Winzer, Ralf; Klinker, Hartwig; Langmann, Peter

doi:10.1007/s15010-004-3136-7

Cited by 62 publications

(26 citation statements)

References 13 publications

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“…Therefore, the presence of concomitant diseases and the need to use other drugs, the condition of renal and hepatic function, as the age and nutritional condition are factors that influence the clinical relevance of a determine DI. (Aberg et al, 2006;Bays, 2006;Benesic et al, 2004;Cooper et al, 2003;Hare et al, 2002;Jacobson, 2004;Sax, 2006;Sudano et al, 2006 (Friedland et al, 2005) 3: medium risk FPV (Cao et al, 2008) 3: medium risk IDV 3: medium risk Quetiapine (Hantson et al, 2010) ATV 2: high risk Plasma concentrations and effects of quetiapine are increased, due to inhibitory effect of atazanavir. Recommendation: dose adjustment of quetiapine and monitoring Antineoplasics (Levêque et al, 2009;Makinson et al, 2010…”

Section: Drug Interactions Due To Enzyme Inhibition Mediated By Pis Omentioning

confidence: 99%

“…Also, it is suggested to monitor muscle toxicity signs and symptoms or to use statins less likely to have this type of interaction, such as pravastatin, fluvastatin or rosuvastatin from. (Benesic et al, 2004;DHHS, 2011;Jacobson, 2004;Sax, 2006) In this regard, statins (simvastatin, lovastatin, and atorvastatin, except pravastatin, fluvastatin, and rosuvastatin) are metabolized by CYP3A4 and, therefore, their use should be avoided in patients using PIs, especially ritonavir, atazanavir and saquinavir. Both metabolism and levels of pravastatin, as well as, most likely, fluvastatin and rosuvastatin are slightly affected by the combined use of ritonavir, indinavir, atazanavir, saquinavir, and nelfinavir and therefore they could be combined in patients receiving cART or HAART.…”

Section: Drug Group or Drugs Affectedmentioning

confidence: 99%

“…Both metabolism and levels of pravastatin, as well as, most likely, fluvastatin and rosuvastatin are slightly affected by the combined use of ritonavir, indinavir, atazanavir, saquinavir, and nelfinavir and therefore they could be combined in patients receiving cART or HAART. (Aberg et al, 2006;Bays, 2006;Benesic et al, 2004;Cooper et al, 2003;Jacobson, 2004;Sudano et al, 2006). However, in some cases it may be necessary to increase the dose of pravastatin, as appears likely in the case of nelfinavir.…”

Section: Drug Group or Drugs Affectedmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Relevance of Drug Interactions in HIV-Infected Patients Receiving Antiretroviral Therapy

Amariles¹,

Alzate²,

Faus³

2011

Understanding HIV/AIDS Management and Care - Pandemic Approaches in the 21st Century

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Section: Drug Interactions Due To Enzyme Inhibition Mediated By Pis Omentioning

confidence: 99%

Section: Drug Group or Drugs Affectedmentioning

confidence: 99%

Section: Drug Group or Drugs Affectedmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Relevance of Drug Interactions in HIV-Infected Patients Receiving Antiretroviral Therapy

Amariles¹,

Alzate²,

Faus³

2011

Understanding HIV/AIDS Management and Care - Pandemic Approaches in the 21st Century

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“…Pravastatin, in a double-blind, placebo-controlled study, reduced 118 Other studies have also reported that pravastatin and £uvastatin reduce plasma cholesterol concentrations in HAART patients and are reasonably well tolerated. 119,120 In addition to improving lipids in PI-induced HIV dyslipidaemia, statins have also been shown to reduce HIV-1 replication by interrupting the interaction of integrin intercellular adhesion molecule with HIV's natural cell membrane ligand LFA-1. 121 In a human lymphoma cell model, lovastatin potentiated the antitumour actions of saquinavir.…”

Section: Treatment Of Human Immunodeficiency Virus Related Dyslipidaementioning

confidence: 99%

The basis and management of metabolic abnormalities associated with cardiovascular risk in human immunodeficiency virus infection and its treatment

Crook

2007

Ann Clin Biochem

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This article was prepared at the invitation of the Clinical Sciences Review Committee of the Association for Clinical BiochemistryThe high global prevalence of human immunodeficiency virus (HIV) infection has been associated with high morbidity and mortality. The advent of highly active antiretroviral therapy (HAART) has, however, dramatically increased survival of patients infected with HIV. These patients now survive to develop metabolic complications of HIV infection and its treatment, including increased predisposition to atherosclerotic disease. HIV infection is normally associated with hypocholesterolaemia, hypertriglyceridaemia, low plasma HDL-cholesterol as well as alterations in other cardiovascular risk factors including inflammatory markers, clotting factors, homocysteine, apolipoproteins, lipoprotein (a), oxidative stress and non-esterified fatty acids. The use of HAART is, in particular, associated with dyslipidaemia and lipodystrophy with underlying insulin resistance and associated glucose intolerance. This article explores the metabolic abnormalities associated with increased cardiovascular risk that occur in HIV infection before and after antiretroviral therapy. The laboratory investigation and clinical management of HIVassociated dyslipidaemia and lipodystrophy will be discussed.

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“…Small clinical trials suggest that pravastatin and fluvastatin reduce concentrations of total and low-density lipoprotein cholesterol (LDL-C) without substantial adverse effects [18][19][20][21]. Pharmacokinetic studies suggest that simvastatin should be avoided and atorvastatin used with caution in persons taking ritonavir and saquinavir because of drug-drug interactions [22].…”

Section: Introductionmentioning

confidence: 99%

Use of metabolic drugs and fish oil in HIV‐positive patients with metabolic complications and associations with dyslipidaemia and treatment targets

et al. 2007

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BackgroundHighly active antiretroviral therapy (HAART) with protease inhibitors (PI) is successful in suppressing viral replication, but may lead to a range of metabolic abnormalities associated with cardiovascular disease (CVD). ObjectivesThe first objective of the study was to compare baseline demographic and clinical characteristics between PI users and non-PI users referred to a specialized metabolic clinic during [1999][2000][2001][2002][2003]. The second objective was to assess the associations of prescription drugs and fish oil with dyslipidaemia and to determine whether or not patients achieved treatment targets during 6 months of treatment. MethodsA retrospective analysis was performed using two sets of charts based on standardized forms with entries for personal data, drug treatment and clinical history. Anonymous linkage with the British Columbia HIV/AIDS Drug Treatment Program and the hospital laboratory was performed to gather information about HAART prescriptions and blood work. ResultsIn total, 237 patients were included in the study. There were few differences in any demographic or clinical factors between PI users and non-PI users. Compared with controls not taking lipid-lowering drugs or fish oil (n 5 48), statins appeared to be the only agent that was significantly associated with a reduced total cholesterol concentration ( À 15.6%; P 5 0.009). Fibrate treatment was associated with the largest reduction of triglyceride concentration ( À 37.4%; P 5 0.012), closely followed by fish oil (n 5 18; À 32%; P 5 0.027). Six-month treatment success rates ranged between 17 and 43% of patients for total cholesterol (o5.2 mmol/L) and between 15 and 44% of patients for triglycerides (o2.3 mmol/L). ConclusionsDespite the apparent lowering of blood lipids with drug and fish oil treatments, a majority of patients in these treatment groups (56.5-83.3%) still had elevated concentrations after 6 months. expectancy in HIV-positive men and women [2]. Although HAART regimens are able to suppress viral replication, there is evidence that some antiretroviral drugs are associated with a range of metabolic abnormalities that lead to cardiovascular disease (CVD) [3][4][5][6][7][8][9]. Numerous population-based cohort studies have suggested that some protease inhibitors (PIs) are more strongly associated with dyslipidaemia than others [10,11]. For example, hypertriglyceridaemia appears to be more frequent and more severe with ritonavir than with indinavir. In addition, the use of PIs has also been shown to more frequently result in endothelial dysfunction [12] and coronary artery calcification [13]. CVD may be caused by accelerated atherosclerosis [12,14] resulting from side effects of antiretroviral therapy (ART) such as dyslipidaemia, insulin resistance and lipodystrophy [15]. Compared with the general population of a similar age, HIV-positive patients have a lower prevalence of hypertension, a lower mean high-density lipoprotein cholesterol (HDL-C) concentration, a higher prevalence of smoking, a higher mean waist-to-h...

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Lipid Lowering Therapy with Fluvastatin and Pravastatin in Patients with HIV Infection and Antiretroviral Therapy: Comparison of Efficacy and Interaction with Indinavir

Cited by 62 publications

References 13 publications

Clinical Relevance of Drug Interactions in HIV-Infected Patients Receiving Antiretroviral Therapy

Clinical Relevance of Drug Interactions in HIV-Infected Patients Receiving Antiretroviral Therapy

The basis and management of metabolic abnormalities associated with cardiovascular risk in human immunodeficiency virus infection and its treatment

Use of metabolic drugs and fish oil in HIV‐positive patients with metabolic complications and associations with dyslipidaemia and treatment targets

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