title: Use of rosuvastatin in HIV-associated chronic obstructive pulmonary disease.
abstract: Chronic obstructive pulmonary disease (COPD) is more prevalent in HIV-infected individuals and is associated with persistent inflammation. Therapies unique to HIV are lacking. We performed a pilot study of the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor rosuvastatin to determine effects on lung function.
  
  
  
  Randomized, placebo-controlled, triple-blinded trial.
  
  
  
  HIV-infected individuals with abnormal lung function were recruited from an ongoing lung function study. Participants were randomized to 24 weeks of placebo (n = 11) or rosuvastatin (n = 11) using an adaptive randomization based on change in peripheral C-reactive protein levels at 30 days of treatment. Forced expiratory volume in 1 s (FEV1) and diffusing capacity for carbon monoxide (DLco)%-predicted were compared to baseline at 24 weeks in the two groups using a Wilcoxon rank-sum test. The %-predicted change at 24 weeks in pulmonary function variables was compared between groups using simulated randomization tests.
  
  
  
  The placebo group experienced a significant decline in FEV1%-predicted (P = 0.027), and no change in DLco%-predicted over 24 weeks. In contrast, FEV1%-predicted remained stable in the rosuvastatin group, and DLco%-predicted increased significantly (P = 0.027). There was no significant difference in absolute change in either measure between placebo and rosuvastatin groups.
  
  
  
  In a pilot study, the use of rosuvastatin for 24 weeks appeared to slow worsening of airflow obstruction and to improve DLco in HIV-infected individuals with abnormal lung function, although comparison of absolute changes between the groups did not reach significance. This study is the first to test a therapy for COPD in an HIV-infected population, and large-scale clinical trials are needed.
authors.affiliation: aDepartment of Medicine bEpidemiology Data Coordinating Center, University of Pittsburgh School of Medicine cGraduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania dDepartment of Medicine, University of California San Francisco, San Francisco, California eDepartment of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania fDepartment of Medicine, University of California Los Angeles, Los Angeles, California, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Morris
authors.forename: Meghan
authors.initials: M
authors.lastname: Fitzpatrick
authors.forename: Marnie
authors.initials: M
authors.lastname: Bertolet
authors.forename: Shulin
authors.initials: S
authors.lastname: Qin
authors.forename: Lawrence
authors.initials: L
authors.lastname: Kingsley
authors.forename: Nicolas
authors.initials: N
authors.lastname: Leo
authors.forename: Cathy
authors.initials: C
authors.lastname: Kessinger
authors.forename: Heather
authors.initials: H
authors.lastname: Michael
authors.forename: Deborah
authors.initials: D
authors.lastname: Mcmahon
authors.forename: Renee
authors.initials: R
authors.lastname: Weinman
authors.forename: Stephen
authors.initials: S
authors.lastname: Stone
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Leader
authors.forename: Eric
authors.initials: E
authors.lastname: Kleerup
authors.forename: Laurence
authors.initials: L
authors.lastname: Huang
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Wisniewski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010919:Placebos / Q000008:administration & dosage; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012129:Respiratory Function Tests; D000068718:Rosuvastatin Calcium / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000924:Anticholesteremic Agents; D010919:Placebos; D000068718:Rosuvastatin Calcium