4.4 Article

Impact of rosuvastatin on atherosclerosis in people with HIV at moderate cardiovascular risk: a randomised, controlled trial

期刊

AIDS
卷 35, 期 4, 页码 619-624

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0000000000002764

关键词

atherosclerosis; cardiovascular disease; HIV; primary prevention; statins

资金

  1. Faculty of Medicine, Nursing and Health Sciences, Monash University
  2. National Health and Medical Research Council of Australia
  3. Swiss Foundation of Cardiology
  4. Swiss National Foundation
  5. Boninchi Foundation

向作者/读者索取更多资源

Prescribing statins at a lower threshold than guidelines in PLHIV did not lead to improvements in CIMT but was associated with significant adverse events.
Background: : People living with HIV-1 (PLHIV) are at increased risk for cardiovascular disease. Objective: This study aimed to determine if PLHIV would benefit from starting statins at a lower threshold than currently recommended in the general population. Design: A double-blind multicentre, randomised, placebo-controlled trial was performed. Methods: Participants (n = 88) with well controlled HIV, at moderate cardiovascular risk (Framingham score of 10-15%), and not recommended for statins were recruited from Australia and Switzerland. They were randomized 1 : 1 to rosuvastatin (n = 44) 20 mg daily, 10 mg if co-administered with ritonavir/cobicistat-boosted antiretroviral therapy, or placebo (n = 40) for 96 weeks. Assessments including fasting blood collection and carotid--intima media thickness (CIMT) were performed at baseline, and weeks 48 and 96. The primary outcome was the change from baseline to week 96 in CIMT (clinicaltrials.gov: NCT01813357). Results: Participants were predominantly men [82 (97.6%); mean age 54 years (SD 6.0)]. At 96 weeks, there was no difference in the progression of CIMT between the rosuvastatin (mean 0.004 mm, SE 0.0036) and placebo (0.0062 mm, SE 0.0039) arms (P = 0.684), leading to no difference in CIMT levels between groups at week 96 [rosuvastatin arm, 0.7232 mm (SE 0.030); placebo arm 0.7785 mm (SE 0.032), P = 0.075]. Adverse events were common (n = 146) and predominantly in the rosuvastatin arm [108 (73.9%)]. Participants on rosuvastatin were more likely to cease study medication because of an adverse event [7 (15.9%) vs. 2 (5.0%), P = 0.011]. Conclusion: In PLHIV, statins prescribed at a lower threshold than guidelines did not lead to improvements in CIMT but was associated with significant adverse events.

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