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Abstract
Ezetimibe combined with low dose statin effectively lowers LDL in protease inhibitor treated patients
Klibanov O.M.1, Gaughan J.P.1, Tedaldi E.M.1, Lattanzi K.M.1, Parekh A.N.1, Gallagher K.A.2, Rivero R.O.2, van den Berg-Wolf M.1
Objectives: Ezetimibe (EZB) lowers cholesterol by blocking cholesterol absorption in the intestine. Data regarding its use are limited in HIV-infected patients. Our main objective was to assess LDL reduction 18 weeks after addition of EZB 10mg/day in statin-treated patients on protease inhibitor (PI)-based antiretroviral therapy (ART).
Methods: HIV-infected adults on stable PI-based ART were enrolled in this prospective pilot study if their LDL was not at goal (per National Cholesterol Education Program III guidelines) despite therapy with a statin (pravastatin 20 mg or atorvastatin 10 mg). In a subgroup of patients on lopinavir/ritonavir (LPV/RTV), trough LPV and RTV concentrations were obtained before and after addition of EZB. Data were analyzed using repeated measures ANOVA on ranks with Bonferroni adjustment.
Results: We enrolled 20 subjects; 12 (60%) men, 18 (90%) African American, 2 (10%) Latino; mean (SD) age was 49.1 (8.5) years. ART included RTV-boosted PIs in 17 (85%) patients, 3 (15%) were on nelfinavir; 19 were on pravastatin, 1 on atorvastatin. Cholesterol changes are described in the table. Thirteen patients were receiving LPV/RTV; LPV and RTV trough concentrations did not change after addition of EZB. One patient experienced elevated creatine phosphokinase (CPK) possibly related to study medication; no other laboratory abnormalities or adverse effects were seen.
| Mean (SD) | BL (n=20) | Wk 6 (n=20) | p-value | Wk 12 (n=20) | p-value | Wk 18 (n=16) | p-value | | TC (mg/dL) | 228.8 (42.4) | 203.4 (37.7) | 0.003 | 206.9 (35.8) | 0.008 | 208.1 (37.3) | 0.031 | | LDL (mg/dL) | 139.3 (25.4) | 124.1 (33.6) | 0.039 | 122.4 (28.8) | 0.010 | 122.0 (26.8) | 0.023 | | TG (mg/dL) | 163.3 (112.6) | 150.4 (70.9) | NS | 162.4 (102.3) | NS | 156.8 (64.6) | NS | | HDL (mg/dL) | 60.2 (23.9) | 58.6 (16.6) | NS | 58.3 (18.8) | NS | 56.9 (17.6) | NS |
Conclusions: Addition of EZB to low dose statin effectively lowers LDL and TC and appears to be safe and well-tolerated.
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
Abstract no.
TUPEB076
Suggested Citation
"KlibanovO.M., et al.
Ezetimibe combined with low dose statin effectively lowers LDL in protease inhibitor treated patients.
Poster exhibition:
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention:
Abstract no.
TUPEB076"
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