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Rosuvastatin versus pravastatin in dyslipidemic HIV-1-infected patients receiving protease inhibitors: a randomized trial.
AIDS. 2010 Jan 02; 24(1):77-83.AIDS

Abstract

BACKGROUND

HIV infection and its treatment with protease inhibitors, especially when boosted with ritonavir, can cause lipid disorders. Statins, with the exception of fluvastatin, pravastatin and rosuvastatin, interact with protease inhibitor metabolism via CYP450. Pravastatin is recommended for patients with protease inhibitor-associated dyslipidemia. Rosuvastatin is the statin most effective on low-density lipoprotein cholesterol (LDL-c) in non-HIV patients.

METHODS

HIV-1-infected patients treated with boosted protease inhibitor were randomized to receive either rosuvastatin 10 mg/day or pravastatin 40 mg/day for dyslipidemia (LDL-c >4.1 mmol/l and triglycerides <8.8 mmol/l). The percentage change in LDL-c, triglyceride and high-density lipoprotein-cholesterol levels, measured in a central laboratory, was determined after 45 days of statin treatment.

RESULTS

Eighty-eight patients were randomized and 83 took the study drugs, 41 rosuvastatin and 42 pravastatin. The median duration of prior antiretroviral treatment was 9 years. At baseline, the median LDL-c level was 4.93 mmol/l, the triglyceride level 2.29 mmol/l, and the high-density lipoprotein-cholesterol level 1.27 mmol/l. The median percentage changes in the rosuvastatin and pravastatin arms were -37 and -19% for LDL-c (P < 0.001), respectively, and -19 and -7% for triglycerides (P = 0.035), respectively. The change in the high-density lipoprotein-cholesterol level was not significantly different between the two arms. None of the four severe adverse events was attributed to the statins; in particular, there were no renal, hepatic or muscular events.

CONCLUSION

Rosuvastatin 10 mg/day was more effective than pravastatin 40 mg/day on LDL-c and triglyceride levels in HIV-1-infected patients receiving a boosted protease inhibitor.

Authors+Show Affiliations

Université Paris Descartes, France. elisabeth.aslangul@htd.aphp.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19838098

Citation

Aslangul, Elisabeth, et al. "Rosuvastatin Versus Pravastatin in Dyslipidemic HIV-1-infected Patients Receiving Protease Inhibitors: a Randomized Trial." AIDS (London, England), vol. 24, no. 1, 2010, pp. 77-83.
Aslangul E, Assoumou L, Bittar R, et al. Rosuvastatin versus pravastatin in dyslipidemic HIV-1-infected patients receiving protease inhibitors: a randomized trial. AIDS. 2010;24(1):77-83.
Aslangul, E., Assoumou, L., Bittar, R., Valantin, M. A., Kalmykova, O., Peytavin, G., Fiévet, M. H., Boccara, F., Bonnefont-Rousselot, D., Melchior, J. C., Giral, P., & Costagliola, D. (2010). Rosuvastatin versus pravastatin in dyslipidemic HIV-1-infected patients receiving protease inhibitors: a randomized trial. AIDS (London, England), 24(1), 77-83. https://doi.org/10.1097/QAD.0b013e328331d2ab
Aslangul E, et al. Rosuvastatin Versus Pravastatin in Dyslipidemic HIV-1-infected Patients Receiving Protease Inhibitors: a Randomized Trial. AIDS. 2010 Jan 2;24(1):77-83. PubMed PMID: 19838098.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rosuvastatin versus pravastatin in dyslipidemic HIV-1-infected patients receiving protease inhibitors: a randomized trial. AU - Aslangul,Elisabeth, AU - Assoumou,Lambert, AU - Bittar,Randa, AU - Valantin,Marc-Antoine, AU - Kalmykova,Olga, AU - Peytavin,Gilles, AU - Fiévet,Marie-Hélène, AU - Boccara,Franck, AU - Bonnefont-Rousselot,Dominique, AU - Melchior,Jean-Claude, AU - Giral,Philippe, AU - Costagliola,Dominique, PY - 2009/10/20/entrez PY - 2009/10/20/pubmed PY - 2010/12/29/medline SP - 77 EP - 83 JF - AIDS (London, England) JO - AIDS VL - 24 IS - 1 N2 - BACKGROUND: HIV infection and its treatment with protease inhibitors, especially when boosted with ritonavir, can cause lipid disorders. Statins, with the exception of fluvastatin, pravastatin and rosuvastatin, interact with protease inhibitor metabolism via CYP450. Pravastatin is recommended for patients with protease inhibitor-associated dyslipidemia. Rosuvastatin is the statin most effective on low-density lipoprotein cholesterol (LDL-c) in non-HIV patients. METHODS: HIV-1-infected patients treated with boosted protease inhibitor were randomized to receive either rosuvastatin 10 mg/day or pravastatin 40 mg/day for dyslipidemia (LDL-c >4.1 mmol/l and triglycerides <8.8 mmol/l). The percentage change in LDL-c, triglyceride and high-density lipoprotein-cholesterol levels, measured in a central laboratory, was determined after 45 days of statin treatment. RESULTS: Eighty-eight patients were randomized and 83 took the study drugs, 41 rosuvastatin and 42 pravastatin. The median duration of prior antiretroviral treatment was 9 years. At baseline, the median LDL-c level was 4.93 mmol/l, the triglyceride level 2.29 mmol/l, and the high-density lipoprotein-cholesterol level 1.27 mmol/l. The median percentage changes in the rosuvastatin and pravastatin arms were -37 and -19% for LDL-c (P < 0.001), respectively, and -19 and -7% for triglycerides (P = 0.035), respectively. The change in the high-density lipoprotein-cholesterol level was not significantly different between the two arms. None of the four severe adverse events was attributed to the statins; in particular, there were no renal, hepatic or muscular events. CONCLUSION: Rosuvastatin 10 mg/day was more effective than pravastatin 40 mg/day on LDL-c and triglyceride levels in HIV-1-infected patients receiving a boosted protease inhibitor. SN - 1473-5571 UR - https://www.unboundmedicine.com/medline/citation/19838098/Rosuvastatin_versus_pravastatin_in_dyslipidemic_HIV_1_infected_patients_receiving_protease_inhibitors:_a_randomized_trial_ L2 - https://doi.org/10.1097/QAD.0b013e328331d2ab DB - PRIME DP - Unbound Medicine ER -