Carotid intima media thickness, inflammatory markers, and endothelial activation markers in HIV Patients with lipoatrophy increased at 48 weeks regardless of use of rosiglitazone or placebo.
Rosiglitazone may be useful for the treatment of antiretroviral therapy-associated lipoatrophy, but an association with cardiovascular disease (CVD) has been questioned in diabetics. We evaluated rosiglitazone's effect on surrogate markers of CVD in HIV-infected individuals with lipoatrophy. HIV(+) patients with lipoatrophy on thymidine-sparing regimens were randomized to rosiglitazone vs. placebo for 48 weeks. We serially assessed carotid IMT, fasting metabolic profiles, tumor necrosis factor (TNF)-α, soluble receptors (sTNFRI and II), interleukin (IL)-6, high-sensitivity C-reactive protein (hsCRP), myeloperoxidase (MPO), and endothelial activation markers [von Willebrand factor (vWF), soluble intercellular cell adhesion molecules-1 (sICAM-1), and vascular cell adhesion molecules-1 (sVCAM-1)]. Seventy-one subjects enrolled: 17% were female and 51%were white. Baseline characteristics were similar between groups except for higher total cholesterol in the placebo group (p = 0.04). At 48 weeks, common carotid artery (CCA) IMT changed significantly (p ≤ 0.05) within but not between the groups (p = 0.36): the median (IQR) increase was 0.10 (0.05, 0.25) mm and 0.15 (0, 0.25) mm in the rosiglitazone and placebo groups, respectively. hsCRP, sTNFRI and II, sVCAM-1, and vWF changed significantly (p ≤ 0.02) within but not between groups. Total cholesterol increased significantly in the rosiglitazone group (p = 0.008). In our study of virologically controlled subjects with lipoatrophy, rosiglitazone did not independently increase carotid IMT, endothelial activation, and inflammatory cytokines.
Tungsiripat
Marisa
M
Cleveland Clinic, Ohio, USA.
El-Bejjani
Dalia
D
Rizk
Nesrine
N
Dogra
Vikram
V
O'Riordan
Mary Ann
MA
Ross
Allison C
AC
Hileman
Corrilynn
C
Storer
Norma
N
Harrill
Danielle
D
McComsey
Grace A
GA
D000328:Adult; D044966:Anti-Retroviral Agents / Q000009:adverse effects; D015415:Biomarkers / Q000032:analysis; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D017536:Carotid Artery, Common / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D016207:Cytokines / Q000187:drug effects; D003920:Diabetes Mellitus / Q000188:drug therapy; D004730:Endothelium, Vascular / Q000473:pathology; D005121:Extremities / Q000502:physiology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000473:pathology; D008060:Lipodystrophy / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D017539:Tunica Intima / Q000473:pathology*
D044966:Anti-Retroviral Agents; D015415:Biomarkers; D016207:Cytokines; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D002784:Cholesterol