Rosuvastatina para tratamiento de la dislipidemia en pacientes infectados con VIH en tratamiento antirretroviral de gran actividad. Experiencia preliminar

Bottaro, Edgardo; Caravello, Oscar; Scapellato, Pablo; Stambulian, Marcela; Vidal, Gabriela I.; Loggia, V.; Scapellato, José Luis; Thompson, F.M.L.; Cassetti, Isabel

doi:10.1157/13123836

Cited by 9 publications

(14 citation statements)

References 23 publications

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“…In keeping with our findings, others have shown that in HIV-infected patients combination of statin with ezetimibe was more effective in lowering non-HDL-C than statin alone [ 25 ]. Borrato et al have shown that treatment of HIV-infected patients with rosuvastatin 10 mg alone for 16 weeks resulted in a significant reduction of LDL-C as well as non-HDL-C with 65 % of them achieving therapeutic targets [ 26 ]. In rosuvastatin monotherapy, we did not see any significant changes in non-HDL-C.…”

Section: Discussionmentioning

confidence: 99%

Lipid lowering efficacy and safety of Ezetimibe combined with rosuvastatin compared with titrating rosuvastatin monotherapy in HIV-positive patients

et al. 2015

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BackgroundHIV-infected patients on antiretroviral therapy frequently develop dyslipidemias and, despite therapy with potent lipid-lowering agents, a high percentage does not achieve guideline recommended lipid targets. In this study, we examined the efficacy of combination treatment with a statin and the cholesterol transport blocker, ezetimibe, vs. monotherapy with a statin in HIV-infected patients not achieving lipid goals.MethodsThis was a 12-week, prospective, randomized, open-label clinical trial. Patients were eligible if they had an apolipoprotein B (apoB) >0.80 g/L despite therapy with rosuvastatin 10 mg daily for a minimum of 12 weeks. Patients were randomized to take ezetimibe 10 mg/rosuvastatin 10 mg or rosuvastatin 20 mg for 12 weeks. Percentage and absolute change in apoB (primary outcome), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, apoliporpotein A1 (apoA1), apoB/apoA1, TC/HDL-C, atherogenic index of plasma (API), and high-sensitivity C-reactive protein (hsCRP) were compared. Changes in safety parameters (such as AST, ALT, CK) and clinical symptoms were also assessed.ResultsForty-three patients (23 on ezetimibe 10 mg/rosuvastatin 10 mg and 20 on rosuvastatin 20 mg) completed the trial. Baseline characteristics did not differ between the groups. Significant improvements in apoB were seen with both ezetimibe plus rosuvastatin (mean of -0.17 g/L, p < 0.001) and rosuvastatin 20 mg (mean of -0.13 g/L, p = 0.03) treatment groups, but did not differ between groups (p = 0.53). Significant between-group differences were observed for mean TC (-1.01 mmol/L vs. -0.50 mmol/L, p = 0.03), TG (-0.62 mmol/L vs -0.17 mmol/L, p = 0.03), and non-HDL-C (-0.97 mmol/L vs. -0.53 mmol/L, p = 0.03) all in favour of the ezetimibe plus rosuvastatin group. Two patients, both in the rosuvastatin 20 mg group, experienced mild myalgias; neither discontinued the study.ConclusionsThe addition of ezetimibe to rosuvastatin appears to be safe in patients with HIV. Furthermore, the combination of ezetimibe and rosuvastatin improved TG, AIP and non-HDL cholesterol levels more than a dose increase in rosuvastatin in patients with HIV-associated dyslipidemia.

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Section: Discussionmentioning

confidence: 99%

Lipid lowering efficacy and safety of Ezetimibe combined with rosuvastatin compared with titrating rosuvastatin monotherapy in HIV-positive patients

et al. 2015

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“…In the research of Bottero et al [27], the use of rosuvastatin (10 mg/day) was retrospective evaluated during 16 weeks in HAART-treated HIV-infected persons with dyslipidemia. Seventy eight patients started on rosuvastatin, sixty as monotherapy.…”

Section: Pathogenesis For Dyslipidemiamentioning

confidence: 99%

New Options in the Treatment of Lipid Disorders in HIV-Infected Patients

Silva¹,

Bárbaro²

2009

TOAIDJ

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Since the introduction of HAART, there was a remarkably change in the natural history of HIV disease, leading to a notable extension of life expectancy, although prolonged metabolic imbalances could significantly act on the longterm prognosis and outcome of HIV-infected persons, and there is an increasing concern about the cardiovascular risk in this population. Current recommendations suggest that HIV-infected perons undergo evaluation and treatment on the basis of the Third National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP ATP III) guidelines for dyslipidemia, with particular attention to potential drug interactions with antiretroviral agents and maintenance of virologic control of HIV infection. While a hypolipidemic diet and physical activity may certainly improve dyslipidemia, pharmacological treatment becomes indispensable when serum lipid are excessively high for a long time or the patient has a high cardiovascular risk, since the suspension or change of an effective antiretroviral therapy is not recommended. Moreover, the choice of a hypolipidemic drug is often a reason of concern, since expected drug-drug interactions (especially with antiretroviral agents), toxicity, intolerance, effects on concurrent HIV-related disease and decrease patient adherence to multiple pharmacological regimens must be carefully evaluated. Often the lipid goals of patients in this group are not achieved by the therapy recommended in the current lipid guidelines and in this article we describe other possibilities to treat lipid disorders in HIV-infected persons, like rosuvastatin, ezetimibe and fish oil.

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“… 35 They developed myalgia or gastrointestinal complaints, while one participant had a prominent CPK elevation (19 000 UI/L). 35 Smiderle et al studied patients on simvastatin or atorvastatin and found an ADRs frequency of 14.9%; myalgia or abnormalities in CPK and/or LFTs were described. 37 Meanwhile, Santos et al assessed LDL receptor mutations in familial hypercholesterolaemia subjects on atorvastatin and found that 11.6% and 0% of the participants developed myalgia and rhabdomyolysis, respectively, during a 1-year follow-up.…”

Section: Resultsmentioning

confidence: 97%

“… 35 37 39 40 42 Bottaro et al assessed rosuvastatin in an HIV-positive population on antiretroviral therapy and found that 3.8% developed ADRs. 35 They developed myalgia or gastrointestinal complaints, while one participant had a prominent CPK elevation (19 000 UI/L). 35 Smiderle et al studied patients on simvastatin or atorvastatin and found an ADRs frequency of 14.9%; myalgia or abnormalities in CPK and/or LFTs were described.…”

Section: Resultsmentioning

confidence: 99%

Statin associated adverse reactions in Latin America: a scoping review

Urina-Jassir¹,

Pacheco

Páez-Canro

et al. 2021

BMJ Open

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ObjectivesWe aim to describe the frequency and type of adverse drug reactions (ADRs) in patients on statins in published studies from Latin American (LATAM) countries.DesignScoping review.MethodsA literature search was conducted in three databases (PubMed, EMBASE and LILACS) in addition to a manual search in relevant journals from LATAM universities or medical societies. A snowballing technique was used to identify further references. Randomised controlled trials (RCTs) and observational studies between 2000 and 2020 were included. Studies were considered eligible if they included adults on statin therapy from LATAM and reported data on ADRs. Data on ADRs were abstracted and presented by study design.ResultsOut of 8076 articles, a total of 20 studies were included (7 RCTs and 13 observational studies). We identified three head-to-head statin RCTs, two statin-versus-policosanol RCTs and only two placebo-controlled trials. The statin-related ADRs frequency ranged from 0% to 35.1% in RCTs and 0% to 28.4% in observational studies. The most common ADRs were muscle-related events including myalgia and elevated creatine phosphokinase. Other reported ADRs were gastrointestinal symptoms, headache and altered fasting plasma glucose.ConclusionsWe identified differences in the frequency of ADRs in both observational studies and RCTs from LATAM countries. This could be due to the absence of standard definitions and reporting of ADRs as well as differences among the study’s interventions, population characteristics or design. The variability of ADRs and the absence of definitions are similar to studies from other geographical locations. Further placebo-controlled trials and real-world data registries with universal definitions should follow.

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Rosuvastatina para tratamiento de la dislipidemia en pacientes infectados con VIH en tratamiento antirretroviral de gran actividad. Experiencia preliminar

Cited by 9 publications

References 23 publications

Lipid lowering efficacy and safety of Ezetimibe combined with rosuvastatin compared with titrating rosuvastatin monotherapy in HIV-positive patients

Lipid lowering efficacy and safety of Ezetimibe combined with rosuvastatin compared with titrating rosuvastatin monotherapy in HIV-positive patients

New Options in the Treatment of Lipid Disorders in HIV-Infected Patients

Statin associated adverse reactions in Latin America: a scoping review

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